MEDICA
twentieth century
household physician
22900261376
3 os S’ ^
Digitized by the Internet Archive
in 2016
https ://arch i ve . org/detai I s/b281 39616
IMPORTANT NOTICE
■mHEREVER numbers are seen in pa-
rentheses— for example, on page 208,
under Treatment for Lead Palsy will be
seen (3J), (32), 246) — these numbers re-
fer to the Prescriptions to be used; said pre-
scriptions begin on page 1100 and are num-
bered from 1 to 375,
For the convenience of the reader we have
divided the indexes as follows:
General Index Pages 1409 to 1426
Index of Simple Home Remedies
Pages 1426 to 1432
Index to Homeopathic Department
Pages 1433 to 1436
Index to Veterinary Department
Pages 1437 to 1440
THE
Household Physician
A TWENTIETH CENTURY MEDICA
A PRACTICAL DESCRIPTION IN PLAIN LANGUAGE OF ALL
THE DISEASES OF MEN. WOMEN AND CHILDREN
WITH THE
LATEST DISCOVERIES IN MEDICINE AND MOST APPROVED
METHODS OF TREATMENT. BY A CORPS OF EMINENT
SPECIALISTS, PRACTISING PHYSICIANS AND SURGEONS
HERBERT E. BUFFUM, M.D.
Fellow of the Massachusetts Medical
Society.
IRA WARREN, A.M., M.D.
Fellow of the Massachusetts Medical
Society, etc.
WILLIAM THORNDIKE, M.D.
Fellow of the Medical Society, and Mem-
ber of Society for the Improvement
of Medicine, etc., and others.
A. T. LOVERING, M.D.
Member of the Faculty of University
School of Medicine
Member Boston Homoeopathic
Medical Society
A. E. SMALL, A.M., M.D.
Ex-President of the Hahnemann
Medical College
J. HEBER SMITH, M.D.
Professor of Materia Medica, Univer-
sity School of Medicine, and late
President of Massachusetts
Homoeopathic Society
Veterinary, CHARLES P. LYMAN, F.R.C.V.S.
Fellow of Royal College of Veterinary Surgeons, England,
President United States Veterinary Medical Association, '
Veterinarian-in-Chief to the Agricultural Department at Washington, D.C.,
Member Massachusetts Veterinary Society,
Professor of Theory and Practice, and Dean of the School of Veterinary Medi-
cine in Harvard University,
Secretary of the Board of Cattle Commissioners of the Commonwealth of
Massachusetts.
FULLY ILLUSTRATED WITH MANIKINS, COLORED AND
HALF-TONE PLATES
THIS BOOK IS PUBLISHED STRICTLY AS A SUBSCRIPTION BOOK AND TOJLBE
SOLD ONLY AS SUCH
Printed in the United States
JOSEPH BEYER & JOSEPH
LONDON, TORONTO AND NEW YORK
igo8
Copyright, 1905
PHYSICIANS’ PUBLISHING CO. (INC.)
0
THE HOUSEHOLD PHYSICIAN
Is registered as a Trade Mark.
Entered in Stationers’ Hall,
London, England.
Right of Translation is Reserved.
ViELLCChimtrm
UBRfiaV
Coll.
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No.
L
m
EMINENT AUTHORITIES CONSULTED
WHOSE WRITINGS AND WORKS ON MEDICINE AND SURGERY
ARE WITHOUT QUESTION THE BEST IN THE WORLD AND
REFERENCE TO WHICH IN TREATMENT OF SPECIAL
DISEASES WE ARE INDEBTED
MEDICINE.
Reginald Fitz, A.M., M.D.
H. C. Wood, A.M., M.D.
Herbert A. Hare, M.D., B.S.C.
VENEREAL DISEASES.
Robert W. Taylor, M.D.
Prof. Isodore Newman of Vienna.
DISEASES OF THE SKIN.
J. N. Hyde, A.M., M.D.
Prof. Moriz Kaposi of Vienna.
DISEASES OF THE EAR.
Dr. Adam Politzer.
MEDICINE.
William Osler, M.D., F.T.S., F.R.C.P.
James M. Anders, M.D., Ph.D., LL.D.,
Philadelphia, Pa.
H. R. Arndt, M.D.
William Borricke, M.D.,
San Francisco, Cal.
J. M. Dacosta, M.D., LL.D.
Dr. Wilhelm v. Leube,
Wurzburg, Germany.
A. C. COWPERTHWAITE, M.D.. Ph.D.,
LL.D., Chicago, III.
Timothy F. Allen, A.M., M.D.,
New York.
DISEASES OF THE EAR, NOSE AND
THROAT.
Seth Scott Bishop, M. D.
Horace F. Ivins, M.D.
D. Braden Kyle, M.D.
E. B. Dench, Ph.B., M.D.
DISEASES OF THE SKIN.
W. Allan Jamieson, M.D., F.R.C.P.,
Edinburgh, Scotland.
SURGERY.
F. S. Dennis, A.M., M.D.
J. A. W. White, M.D., Ph.D.
W. W. Keane, M.D.
CHILDREN’S DISEASES.
Thomas Rotch, A.M., M.D.
DISEASES OF THE EYE.
G. E. deSchweinitz, A.M., M.D.
DISEASES OF WOMEN.
H. J. Garrigues, A.M., M.D.
H. A. Kelley, A.M., M.D.
E. P. Davis, A.M., M.D.
Richard Norris, A.M., M.D.
SURGERY.
William W. Keen, M.D., LL.D.,
Philadelphia, Pa.
Prof. E. con Bergmann,
Berlin, Germany.
C. E. Fisher.
T. L. Macdonald,
Washington.
H. R. Wharton, M.D.
DISEASES OF THE STOMACH.
Prof. C. A. Ewald,
Berlin, Germany.
DISEASES OF THE HEART.
Robert H.' Babcock, A.M., M.D.
VENEREAL DISEASES.
Prince A. Norrow, A.M., M.D.
URINARY ORGANS.
Clifford Mitchell, A.B., M.D.
DISEASES OF CHILDREN.
C. SiGMTJND UND RAHE, M.D.
L. Emmett Holt, M.D., LL.D.
Charles E. Fisher, M.D.
PHARMACODYNAMICS.
Richard Hughes, M.D., F.R.C.P.,
London. Eng.
GYNECOLOGY.
G. R. SouTHwiCK, M.D., Boston.
T. C. Wood, A.M., M.D., Cleveland, O.
C. N. A_. L. Reed, A.M., M.D.,
Cincinnati, O.
HYGIENE.
Charles Harrington, M.D., Boston.
FEVERS.
H. C. Allen, M.D., Chicago, 111.
OTOLOGY.
Gorham Bacon, A.B., M.D.,
New York.
NERVOUS DISEASES.
Francis X. Dercum, A.M., M.D.,
Ph.D., Philadelphia, Pa.
W. R. Gowers, M.D., F.R.C.P.,
F.R.S., London, England.
Dr. Ludwig Hirt,
Breslau.
Charles M. Dana, A.M., M.D.,
New York.
F. Savary Pearce, M.D.,
Philadelphia.
DISEASES OF THE EYE.
L. Webster Fox, A.M., M.D.,
Philadelphia, Pa.
Charles H. May, M.D.,
New York.
PATHOLOGY.
Alfred Stengel, M.D.,
Philadelphia.
RONTGEN RAY.
Carl Beck, M.D., New York.
MENTAL DISEASES.
Henry D. Berkley, M D.,
Baltimore.
S. H. Talcott, A.M., M.D., Ph.D.
Middletown, N. Y.
OBSTETRICS.
J. Clifton Edgar, M.D.,
New York.
B. C. Hirst, M.D.,
Philadelphia, Pa.
G. W. Varman, M.D.,
New York.
PREFACE
TO THE
Household Physician.
This book is written for the people. It is based on the assumption
that every man — the mechanic, the farmer, and the day laborer, as
well as the professional and business man — has a right to all the
knowledge he is capable of acquiring, on all subjects, medicine not
excepted. The book aims, therefore, to popularize and adapt to the
many what has been claimed as belonging only to the few.
We do not hesitate to avow that our sympathies are with the great
masses, who may be called the bone and muscle of the race. They are,
in the main, more shrewd, more endowed with common sense, more
simple and true in their natural instincts, and consequently less per-
verted, than many of those who claim more refinement and a higher
place in the social scale.
“All men,” says Hippocrates, one of the great fathers of medi-
cine, “ought to be acquainted with the medical art. We believe
that knowledge of medicine is the sister and companion of wisdom.”
Such knowledge would shield the many from the impositions of quack-
ery. No one who reads this book thoroughly will be often imposed
upon thereafter by quack nostrums, or quack doctors. Every man’s
physical organization is his own; and he is charged with the responsi-
bility of taking care of it. To do this properly, he needs knowledge
of it, and to withhold this from him is another form of the old oppres-
sion, which decreed knowledge and power to the few, and ignorance
and obedience to the many.
In accordance with the design of the work, it has been written in
plain, simple English, and brought within the comprehension of all
who have medium powers of mind.
2
PREFACE.
This book was prepared by a number of Medical Experts on differ-
ent diseases, the work is not a compilation, but based on large prac-
tice and wide experience. In dealing with each disease we have
aimed to sketch a brief pen-and-ink portrait, so like it that every
reader shall know the original whenever he sees it; we then give, in
the fewest words, the best treatment.
No work of the sort has ever explained the reasons or given the
whys and wherefores of medicine anything like the extent of this
book, thousands of which are on their mission of instruction, and
carrying comfort and relief to as many homes throughout the land.
No pecuniary effort has been spared to include every known dis-
covery of medicine and nursing to make this book absolute perfec-
tion, and to those who make of it a careful and intelligent study,
it will prove to them in value “ its weight in gold.”
The book is extravagantly illustrated with engravings done ex-
pressly for this work; the colored lithographs and manikins were
drawn under the supervision of expert surgeons, and add much to
its value.
PHYSICIANS’ PUBLISHING COMPANY.
IMPORTANT NOTICE
'1X7HEREVER numbers are seen in par-
^ ^ entheses — for example, on page 208.
under Treatment for Lead Palsy will be
seen (31), (32), (246) — these numbers re-
fer to the Prescriptions to be used ; said pre-
scriptions begin on page i 100 and are num-
bered from I to 3 7 5 .
CONTENTS
PAGE
Preface ............. 1
General Introductory Remarks ....... 6-14
Anatomy — Structure of the body — Chemical Properties of the Body — Physi-
cal Properties of the Body — Vital Properties of the Body — Anatomy of
the Bones — Bones of the Head — Bones of the Trunk — Bones of the
Upper Extremities — Bones of the Lower Extremities — ^The Joints — Uses
of the Bones — The Muscles — The Teeth — Uses of the Teeth — Digestive
Organs — Urinary System — Respiratory Organs — Organs of Circulation —
Absorbent Vessels — Organs of Secretion — Vocal Organs — Skin — Nervous
System — Organs of Sight — Organs of Hearing .... 16-57
Hygiene — Life, the Infancy of Being — Nervous System — Sensations — Sym-
pathetic Nervous System — Food and Digestion — Nature and Destination
of Food — Cost of Food — Amount of Food Taken — Animal and Vegetable
Food — Proportions of Animal and Vegetable Food — Tea and Coffee
— Water — Exercise — Passive Exercise — Rest and Sleep — Objects of
Clothing — Bathing and Cleanliness — Air and Ventilation — Travelling —
Amusements .......... 59-127
Temperaments and Constitution of the Body and Symptoms of Diseases —
Medication and Temperaments — ^The Constitution — How to Examine a
Patient — Explanatory Table of Symptoms — ^Temperature of the Body
— Strength and Warmth from Food and Drink — Sickness During Life —
Human Longevity — Weight of the Human Body — Symptoms of Differ-
ent Diseases .......... 128-15S
Skin Diseases — Congestive Inflammation of the Skin — Measles — Scarlet
Fever — Smallpox — Varioloid — Chicken Pox — Cow Pox — Erysipelas —
Nettle Rash — Rose Rash — Inflammatory Blush — Watery Pimples —
Eczema and Salt Rheum — Shingles — Itch — Rupia — Pemphigus — Mattery
Pimples — Crusted Tetter — Papulous Scall — Scaly Eruptions — Leprosy
— Psoriasis — Pityriasis — Dry Pimples — Lupus — Warts and Corns —
Mother’s Marks — Nerves of the Skin — Color of the Skin — Disorders of
the Sweat Glands, Oil Glands and Tubes — Barber’s Itch — Disorders of
the Hair and Tubes — Lice — Bed-Bugs — Freckles — Corns — Bunions —
Dandruff — Baldness ......... 155-185
Diseases of Brain and Nerves — Brain Fever — Softening of the Brain — Ab-
scess of the Brain — Tumors of the Brain — Delirium Tremens — Ine-
briety— Enlargement and Shrinking of the Brain — Water in the Head —
Dropsy of the Brain — Cerebro-Spinal Fever — Diseases of the Spinal Cord
— ^Apoplexy — Sunstroke — Paralysis — Hydrophobia — Locked J aw — ^i-
lepsy— Catalepsy — St. Vitus’ Dance — Cramps — Pains of Nerves — Tic
Douloureux — Sciatica — Insanity — Melancholy- — Mania — Dimentia — I d i-
ocy — Hypochondria — Hiccough — Fainting — Dizziness of the Head —
Nightmare — Headaches ........ 188-234
Diseases of the Throat — Nasal Catarrh — Sore Throat — Inflammation of the
Mucous Membrane — Inflammation of the Windpipe — Elongation of
the Uvula — Tonsilitis — Influenza — La Grippe — Inflammation of the
Epiglottis — Mumps 236- 267
Diseases of the Chest — Consumption — Causes of and Cure for — Diet in Con-
sumption— Bronchitis — Swelling of Lungs — Enlargement of Air Cells —
Pulmonary Apoplexy — Air and Water in the Chest — Pleurisy — Lung
Fever — Pneumonia — Typhoid Pneumonia, etc. — Asthma — Hay Fever
236-304
3
4
CONTENTS.
PAGE.
Diseases of the Heart — Sounds of the Heart — Enlargement of the Ventricles
— Dilatation of the Ventricles — Tumors of the Heart — Softening of the
Heart — Fatty Degeneration of the Heart — Shrinking of the Heart —
Inflammation of the Heart Case — Inflammation of the Heart Case and
Heart — Inflammation of the Lining of the Heart — Disease of the
Heart Valves — Water in the Heart Case — Palpitation of the Heart —
Neuralgia of the Heart — Polypus of the Heart — Displacement of the
Heart 306-322
Diseases of the Abdominal Cavity — Inflammation of the Liver — Congestion
of the Liver — Cirrhosis of the Liver — Inflammation of the Spleen —
Jaundice — Gall Stones — Inflammation of the Stomach — Indigestion —
Dyspepsia — Heart Burn — Cramps in the Stomach — Water Brash —
Vomiting — Seasickness — Milk Sickness — Inflammation of the Peri-
tonium — Inflammation of the Bowels — Appendicitis — Cancer of the
Intestine — Intestinal Obstruction — Colic — Air Swellings — Constipation
— Piles — Diarrhoea — Cholera Morbus — Asiatic Cholera — Dysentery —
Worms — Inflammation of the Kidneys — Inflammation of the Bladder —
Bright’s Disease — Diabetes — Bleeding from the Kidneys — Suppression,
Retention and Inability to Hold Urine — Gravel — Phosphatic Deposits —
Oxalic Deposits — Acid Deposits — Bladder Stones — Dropsy of the Belly
— General Dropsy ......... 324-392
Venereal and Sexual Diseases — Pox — Clap — Self-Pollution . . 394-413
Female Diseases — Inflammation, Ulceration and Enlargement of the Neck
of the Womb — Inflammation of the Ovaries — Whites — Absence of the
Menses — Profuse Menstruation — Painful Menstruation — Green Sickness
—Cessation of the Menses — Hysterics — Polypus of the Womb — Inflam-
mation of the Womb — Falling of the Womb — Tumors of the Womb —
Cancer of the Womb — Ovarian Tumors — Inflammation of the Fallopian
Tubes — Inflammation of the Vagina — Itching of the External Parts —
Tubal Pregnancy — Sterility — Prevention of Pregnancy — Midwifery —
Miscarriage — Abortion — Labor — Antiseptic Dressings — Milk Leg — Child-
Bed Fever — Convulsions — Hemorrhage — Nursing Sore Mouth — Broken
Breast — Sore Nipples — Married Ladies - Calendar .... 415—451
Care of Children and Diseases — How to Nurse Sick Children — Inflammation
of the Mouth — Inflammation of the Gums — Canker of the Mouth —
Difficult Teeth Cutting — Croup — Spasm of the Glottis — Whooping
Cough — Diarrhoea — Summer Complaint — Colic — Falling of the Bowel —
Gastric Fever — Rickets — Mesenteric Disease — Blue Disease — Fits . 483-508
Diseases of the General System — Miscellaneous Diseases — Blood — Anaemia —
Chlorosis — Leucocytosis — Bacteriology — Fever — Typhoid Fever — Pre-
vention of Typhoid — Bilious Remittent Fever — Congestive Fever —
Fever and Ague — Yellow Fever — Rheumatism — Gout — Scrofula — Scurvy
— Purple Disease — Diphtheria — Canker . . . . . 510-540
Diseases Peculiar to Modern Times — Old Age and its Diseases — Changes Oc-
curring in Advanced Life — Medical Treatment of the Old — Diseases of
the Old — Bronchial Flux ........ 542-558
Accidents from Noxious Vapors — Drowning — Lightning — Hanging — Fire —
Water — Poisoning and Antidotes for Same — Mineral Poisoning — Vege-
table and Other Poisons ........ 560-569
Surgical Diseases — Modern Surgery — Inflammation — Suppuration and Abscess
— Mortification — Pyaemia — Ulceration and Ulcers — Boils — Carbuncle —
Malignant Pustule — Burns and Scalds — Frost Bite — Chilblains — Me-
chanical Injuries — Septic Wounds — Incised Wounds — Rules for Examin-
ing and Dressing Wounds — Antiseptic Dressings — Way Wounds Unite
— Punctured Wounds — Lacerated Wounds — Gunshot Wounds — Poisoned
Wounds — Fractures — Way Broken Bones Unite — Dislocations — Sprains
— Pereostitis — Different Diseases of Bones — White Swelling — Bunions —
Tumors — Cancer — Felon — Polypus — Piles — Wry Neck — Deformities of
the Spine — Rupture — Varicose Veins — Aneurisms — Wens — Stye — Op-
thalmia — Imperfect Vision— Short and Long Sight — Affections of the Ear
— Ingrowing Toe Nail — How to Stop Flow of Blood — Compression of
Arteries — Anaesthetics — Care of the Teeth — Ulcer of the Stomach —
Glanders — X-Ray — Radium — Flatfoot — Bandages — How to Put them
on 571-680
CONTENTS.
5
Homosopathic Treatment of Diseases — Forms of Medicine for Administration —
Selecting and Using Remedies — Care of Medicines — General Considera-
tions— Diseases of the Ear — Diseases of the Eye and Eyelids — Diseases
of the Respiratory Organs — Baldness — Ringworm — Blackheads — Ery-
sipelas— Prickly Heat — Malignant Pustule — Skin Diseases — Diseases of
the Digestive Organs — Diseases of Organs of Circulation — Diseases of
the Genito-Urinary Organs — Diseases of Infants and Children — Diseases
of Women — Surgical Diseases — Diseases of the General System and
Miscellaneous Diseases — Diseases of the Nervous System . . 682-892
Processes of Hydropathic Treatment — Different Baths — Sea Bathing — In-
jections— Rules for Using Water — Wet Bandages — Compresses — Wet
Sheet Pack — Wet Dress — Half Pack — Folded Wet Sheet — Rubbing Wet
Sheet — Douche, Shower, Cataract, Hose, Wave, Plunge, Head, Leg, Sitz,
Wash Tub, Sponge, Foot, Nose, Eye and Ear and Mouth Baths . 894-917
Domestic Management of the Sick Room — Fumigation — Freezing Mixtures —
Attendants — Prognostics — Bed Sores — Diet in Disease and Convales-
cence— Fluid Aliments ........ 920-952
Art and Science of Cooking for the Sick Room
How to Prepare Wines and Tonics for the Convalescent
Dieting in Regard to Health ....
“ “ Disease ......
Bathing — Russian, Turkish, Vapor and Other Baths
Medicines and Their Preparations
Proprietary and Patent Medicines
Woman Beautiful — A Treatise on How to Keep Young
Physical Culture — Gymnastics — Dumb-Bell Exercise — Jiu
Course in Physical Culture — ^Whitely Exerciser
. 953-962
. 96.3-969
. 970-972
. 973-974
. 975-978
982-1140
1141-1146
1148-1166
Jitsu — Special
1169-1214
Veterinary Medicine — Definitions — The Pulse — Respiratory Organs — Temper-
' ature — General Diseases Common to all Animals — General Plethora —
Anaemia — Blood Poisoning — Anthrax — Expressions Peculiar to Ani-
mals— Hydrophobia — Rabies — Glanders — T uberculosis — Lockj aw — Pox
— Lump Jaw — Horse Ail — Epizootic — Pneumonia — Distemper — Foot
and Mouth Disease — Texan Cattle Fever — Hemorrhage — Rinderpest —
General Inflammation — Catarrh — Sore Throat — Bronchitis — Heaves —
Asthma — Congestion of the Lungs — Pleurisy — Hydrothorax — Disorders
of Organs of Digestion — Diseases of the Intestines — Diseases of Urinary
Organs — Diseases of the Brain — Diseases of the Spinal Cord — Diseases
of the Skin — Diseased Condition of the Joints — Diseases of the Foot —
Shoeing — Parasitic Diseases — Methods of Giving Medicine — Table of
Doses — Prescriptions ....... 1217-1403
Glossary 1405-1408
H
ILLUSTRATIONS
This book contains about five hundred illustrations, the principal ones of which are
given below.
HALF-TONES.
PAGE.
A Perfect “Cupid Bow” Mouth ....... 1165
A Physical Culture Student . . . . . . . . 1168
Back and Shoulder Development ....... 1171
Bandages ........... 674-680
Blackberry Vine .......... 1097
Body Poise ........... 1149
Cayenne Pepper .......... 1097
Celery ............ 1097
Chest Expansion .......... 1171
Compression of Arteries ......... 658-660
Correct Way to Walk ......... 1149
Dandelion . .......... 1097
Development of the Female Figure after Physical Culture Treatment . 1205
Exercise for Stout Women . . . . . . . . 1151
Exercise for Strengthening the Back ....... 1151
Exercise to Reduce Double Chin . . . . . . . 1159
Exterior of the Cow . ........ 1398
Flatfoot ........... 672
How to Lift the Sick and Injured ....... 568-569
Hydrangea ........... 1098
Jiu-Jitsu Holds 1188-1198
Lemons ............ 1094
Lifting Heavy Dumb-bell ......... 1174
Making the Arms Plump . . . . . . . . 1157
Manicuring ........... 1160
Massaging Forehead . . . . . . . . . 1156
“ Neck and Shoulders ........ 1157
“ Scalp .......... 1163
Medicine Cases .......... 892
Muscles of the Horse ......... 1392
“ “ “ Human Body ........ 31-32
Nerves and Arteries of the Brain . . . . . . . 186
“ of the Face .......... 876
Perfect Arm Development ........ 1173
Plaster Treatment for Wrinkles ....... 1156
Points of the Horse .......... 1389
Poke ............ 1098
Pumpkin ........... 1098
Reduction of Obesity ......... 1203
Removing Hairs from Eyebrows . . . . . . 1163
Rested by Music .......... 1160
Skeleton of the Cow ......... 1399
“ “ “ Horse ......... 1395
“ “ “ Human Body ........ 21
“ “ “ Sheep 1402
“ and Internal Organs of the Dog ...... 1403
Skull Cap 1099
Star Grass ........... 1099
Steaming the Face 1154
ILLUSTRATIONS.
7
PAGE.
Teeth 499
“ of the Cow .......... 1401
“ “ “ Horse . . ... . . 1397
The Way the Baby Should be Held in Quieting and Feeding . 485
Tomato 1098
Tulip Tree 1099
Use of Flesh Brush . . . . . 1154
White Pond Lily .......... 1099
Woman Beautiful .......... 1147
COLORED PLATES.
Manikin of Human Head
Muscles of Human Body .
Manikin of Human Trunk
Nerves of the Human Body
Measles and Scarlet Fever
Small Pox .....
Erysipelas .....
Results of Strong Drink .
Heart, Lungs, Stomach and Kidney .
Syphilitic Eruptions
“ Affections of the Throat
Diseases of the Womb
Womb . . ....
Arteries and Veins of the Human Body
Internal Organs of Human Body
Medicinal Plants (Aloes, etc.)
“ “ (Bittersweet, etc.)
“ “ (Dandelion, etc.)
“ “ (Ground Ivy, etc )
“ “ (Hemlock, etc.)
“ “ (Mullein, etc.)
“ “ (Plantain, etc.)
“ “ (Thoroughwort, etc.)
Internal Organs of Horse .
“ “ “ Cow
“ “ “ Sheep .
" “ *' Dog , , ,
Pacing
page 188
“ 29
‘ 60
‘ 66
‘ 156
‘ 160
‘ 163
‘ 194
‘ 310
‘ 396
‘ 404
‘ 420
‘ 442
■ 658
‘ 682
Between pages 988 and 1064
Facing Title page 1215
“ “ 1272
“ . “ 1306
“ “ 1342
GENERAL INTRODUCTORY
REMARKS
Progress of fledicine
Medicine may be divided into a science and an art. It is a sci-
ence as it presents facts and evolves principles; an art as it consists
of rules for practice. For its present attainments it is indebted partly
to researches scientifically conducted, and partly to empirical dis-
covery.
As a science, medicine is chiefly indebted, and must ever be, to the
members of what is called the “regular profession.” This body of
men embraces a large number who are alike ornaments of the race,
and lights of their profession. It is to the writings of this class that
every student must go who would qualify himself for the proper dis-
charge of the duties of a physician; and he who attempts the prac-
tice of medicine without a knowledge of standard medical writings
is either a fool or a knave — either without the brains to understand
science, or destitute of the honesty to deal fairly with men.
Hydropathy. — Or the plan of treating diseases by water. The
singularly careful avoidance, by the whole medical faculty, for many
ages, of the article of pure water as a medicinal, or, rather, health-
imparting agent, was anything but creditable.
It is now admitted by all sensible men that water, cold and warm,
used at proper times and to a reasonable extent, has great power
over several diseases, and is a powerful promoter of health.
Homoeopathy. — This mode of practice is of comparatively recent
origin; but it has already sunk itself deep into the popular heart,
and has drawn to its support many of the wealthy, the cultivated,
and the intelligent, in our most refined communities. They give
8
GENERAL INTRODUCTORY REMARKS 9
great attention to exercise, diet, etc., — which contribute very power-
fully to preserve health, and to restore it when lost.
Eclectics. — There is a large growing class of physicians, called,
at first, after the founder of the school, Thomsonians. Subsequently,
they were generally known as Botanic Physicians. Now they pass
under the title of Eclectics.
These men, directing their attention, at first, chiefly to cayenne
and lobelia, have gradually extended their zealous researches over
the vegetable kingdom, and have gathered much information worthy
to be preserved.
The education and talents of this class of practitioners have grad-
ually risen, year by year, until they have several medical schools,
where students are well instructed in the principles of medicine, by
men of ability. They have also good literature, especially in the
department of materia medica. The list of remedies they have given
to the world, drawn from our home plants, are of great value. We
regard them as equal to all we were previously in possession of from
the vegetable kingdom. The substitution of vegetable remedies, in
most cases, for mercurials, cannot be too highly prized.
Physiologists. — Besides these various direct practitioners of
medicine, there is the large and intelligent class of physiologists, in-
cluding the phrenologists, who nearly discard medicine, and, appeal-
ing to the laws of life established by the Creator, urge temperance in
eating and drinking; exercise in the open air; securing of pure air
by ventilating dwellings, schoolhouses, and churches; bathing in
cold and warm water; cheerfulness of mind; and the cultivation of
the Christian virtues, as the only rational modes of securing health
and life.
We confess we are inclined to forgive this class their error in ban-
ishing medicine, in view of their zeal and success in disseminating
hygienic information of the utmost value and importance to man-
kind. Put man into harmony with nature, and establish over him
the empire of reason, and their theory would be excellent; but as
things are, medicines are “necessary evils.”
10
GENERAL INTRODUCTORY REMARKS
Progress of Medicine. — The art and science of medicine have
made rapid progress in the last few years and are rapidly advancing.
The Chemistry of Man, commonly called Animal Chemistry, is
opening new sources of light.
The result is that students have now before their minds, and are
endeavoring to solve and act upon as fast as possible, inquiries and
propositions like these : —
What is the chemical composition of the solids and fluids of the
healthy human body?
What is the nature of the changes which occur in the composition
of the solids and fluids during disease?
What alterations in the chemical composition of the solids and
fluids take place during the operation of medicines?
Before it can exert any remote action on the animal economy, a
remedy must be absorbed.
Before it can be absorbed, it must be soluble in the fluids of the
living body.
Medicines are subject to chemical changes during their passage
through the system.
These changes are regulated by ordinary chemical laws, and may,
therefore, to some extent, be foretold and made available in the cure
of disease.
These chemical laws are disturbed and varied, to some extent, by
the law of vitality, — just as the magnetic needle is made to vary by
disturbing forces.
What are these disturbances, and to what extent, and under what
circumstances do they occur?
With these and similar inquiries and propositions before his mind,
diligently studied, a physician can prescribe with intelligent aim.
He will not know everything, to be sure, but what he does know he
will have a reason for knowing. If he give a medicine, he will have
in view the chemical changes of the solids and fluids of the body,
known to be produced by the disease he is combating. He will also
keep in mind the solution of the medicine in the fluids of the body,
GENERAL INTRODUCTORY REMARKS
11
and the chemical reaction between its components and the acids,
alkalies, etc., found in the alimentary tube and elsewhere.
As the science of medicine advances, and becomes liberal and ec-
lectic in its character, gathering from all systems the best attested
facts — medical practitioners, who would meet the wants of the age,
must be men of progress. The light of to-morrow, with them, must
modify and improve the light of to-day. They must knock every
hour for admission into some new apartment of nature.
Need of Liberality. — That medical progress may be real,
physicians must be free from bigotry. They must have no narrow
prejudices against any man, or class of men; but be ready to exam-
ine candidly any new thought or new remedy brought to their notice,
from whatever source it may come.
Conservative Leaders. — There are no influences which hold
so steady a check upon medical progress as the conservative leaders
in many of our medical associations. These men have strong faith
in caste, and in the right of the few to govern the many. In the
low places of society, they look for nothing but ignorance and pov-
erty. These are the men who regard knowledge as a contraband
article. They object very strongly to the enlightenment of all classes
in Anatomy, Hygiene, and Medicine. This prejudice should be elim-
inated.
The True Physician. — How different the character of the true
man and physician. He is genial in his disposition. He has no dis-
likes and antipathies, and hates no men except tyrants. He accepts
knowledge, though it come from the humblest source; believing there
is no experience but will repay a study of it, and no husbandman’s
ploughshare but turns up a soil worth analyzing. He belongs ex-
clusively to no party, and can be approached easily by respectable
men of every stamp.
What is now Wanted. — The foregoing remarks indicate one
great leading want, in order that medical knowledge may increase.
It is liberality in the true and full sense. We want true men in high
places, who will let their light shine everywhere.
12
GENERAL INTRODUCTORY REMARKS
Beyond this, and of nearly equal importance with it, we want med-
ical knowledge diffused among the people. We want — what the
world has never seen — a popular medical literature. We want the
temple of Esculapius pulled down, and the priests turned into the
streets to become teachers of the multitude, rather than worshippers
in the inner sanctuary.
We know this want will be stoutly denied, but not, we think, on
well-considered grounds. We do not think it necessary to confine
a knowledge of the soul to the ministers of religion. There is no
branch of theology which we do not deem it proper for laymen to
study; we even popularize it for our children. In the obscurest towns,
laymen who follow the plough or push the plane, become, in many
cases, eminent theologians. Why should they not study the lower
science which relates to the body? They have not been able to here-
tofore, because its mysteries have been purposely hidden under tech-
nicalities.
It is said that those who begin to read upon medicine, are very apt
to imagine themselves afflicted with the various symptoms they find
described. To some small extent this is true; but it is also true that
the light they obtain relieves them from many apprehensions which
their previous ignorance allowed to prey upon them.
Some physicians oppose the popularizing of this kind of knowledge
too often, we fear, upon the sordid ground of self-interest. They
think their own services will be less sought.
We do not dispense with the services of ministers because the
people study theology, neither shall we cease to employ teachers
and practitioners of medicine when each man and woman is wise
enough to study the healing art. The principal change we shall
witness will be much larger attainments in knowledge among practi-
tioners.
The teachers of any art or science are obliged to keep in advance
of their pupils. Let medicine become a popular study, and we shall
have very few ignorant physicians, and quackery will become one of
the impossibilities. Homoeopathists, Eclectics, Hydropathists, and
GENERAL INTRODUCTORY REMARKS
13
Physiologists believe in scattering medical books, stripped of their
technicalities, among the multitude.
This is one of the missions of this book.
How many men understand the laws of health? How many
women suffer untold agony through pure ignorance of their physical
construction? Children are taught history, mathematics, and other
branches of learning, but know absolutely nothing of their anatomy
— the function of their stomach, lungs, brain, nerves or circulation.
This being the case, is it a wonder so many boys and girls enter matu-
rity unprepared physically for the duties demanded of them, and
consequently suffer for their ignorance? How different and hap-
pier would their future life be if they were to receive proper physical
care and given proper instruction.
This book is written in plain English, imparting knowledge indis-
spensable to the family, father, mother, and children, who, by taking
advantage of this opportunity, by careful and intelligent study, can
learn how to avoid and ward off sickness and disease, as well as to
administer in case of illness to themselves and other members of the
family.
But it must be borne in mind that in many cases, the services of a
physician are indispensable, and unless the reader, by following the
symptoms herein given, is able to diagnose the ailment, and if a
marked improvement is not noticed in the patient from the rem-
edies given, no time should be lost in calling a physician.
PHYSICIANS’ PUBLISHING CO.
WONDERS OF THE HUMAN BODY.
How to Keep Well.
The solar plexus, or brain, never ceases to operate while soul
remains in the temple — never sleeps — therefore never needs to be
awakened. The power — all power — given to the cerebrum and
cerebellum comes from the solar center. Thus digestion of food,
circulation of blood, inhaling-breathing in the aerial elements, is
carried on through the wondrous mechanism of the vascular and
nervous system of man’s body.
The body, flesh, bone, blood, hair, nails, etc., is all that seers,
philosophers, prophets, and alchemists have sought and smig through-
out the centuries. But materialism forever looks away, here and
there, for that which lies between the soles of man’s feet and the
crown of his head. In the language of Epictitus, ‘‘Unhappy man,
thou carriest a god about with thee and knowest it not.”
At maturity the human skeleton contains about 165 bones so
delicately and perfectly adjusted that Science has despaired of ever
imitating it. The muscles are about 500 in number. Length of
alimentary canal 32 feet. Amount of blood in average sized adult
30 pounds, or one fifth the weight of the body.
The heart is six inches in length and four inches in diameter and
beats 70 times per minute, 4200 times per hour, 100,800 per day,
36,720,000 per year; at each beat two and one-half ounces of blood
are thrown out of it, 175 ounces per minute, 656 pounds every hour,
or about eight tons per day. All the blood in the body passes through
the heart every toee minutes. During 70 years the heart lifts
270,000,000 tons.
The lungs will contain about one gallon of air at their usual in-
flation.
We breathe, on an average, 1,200 per hour and inhale 24,000
gallons per day.
The aggregate surface of air cells of the lungs exceeds 20,000 square
inches, an area nearly equal to a room 12 feet square.
The average weight of the brain of an adult male is three pounds
and eight ounces; female, two pounds and four ounces.
The female brain more than makes up in fineness of texture what it
laicks in weight, compared with the male.
14a
146
WONDERS OF THE HUMAN BODY.
The nerves are all connected with the brain directly or by the
spinal marrow.
The nerves, together with their branches and minute ramifications,
exceed 10,000,000 in number, and form a body-guard greater than
any army ever marshalled.
The skin is composed of three layers, and varies from one fourth
of an inch to one inch in thickness. Its average area in an adult is
estimated at 2,000 square inches. The atmospheric pressure being
about 14 pounds to the square inch, a person of medium size is subject
to a pressure of 40,000 pounds. Each square inch of skin contains
3,500 sweating tubes, or perspiratory pores, each of which may be
likened to a little drain tile one fourth of an inch long, making an
aggregate length, of all the pores placed end to end, 202,000 feet or
about 40 miles.
The ashes of an average body weigh four to five pounds.
Air breathed into the arteries (air carriers — the ancients knew)
unites with the cell, salts of iron, potash, lime, etc., the mineral
base of blood, and is thus through the wondrous affinities and alchem-
ical transmutations precipitated as flesh and bone by the same
Infinite Intelligence that materializes vegetables, fruits, or flowers.
The organic portion of food, i.e., the oil, albumen, fibrin, etc., is
consumed, chemically burned in stomach and intestinal tract, to set
free stored-up energy (motion) motive power to run the human ma-
chine, so the process of inhaling air — raw material for blood — may
go on.
Through this chemical process of burning, called digestion, the
mineral salts of iron, potassium, sodium, silica, hme, and magnesia
are set free and enter the circulatory avenues through the dehcate
hair-like tubes that cover the mucous membrane of all internal viscera;
these tubes are called absorbents. The mineral or cell salts are the
foundation of blood.
Chemists now agree that there is but one substance known to
man, and from it all things are made that are made.
The multiple forms of this substance constitute the visible universe.
The body of man is an epitome of the whole.
Mankind is on the verge of the discovery that the universe is a
perfect machine, always in perfect order, and always running, and
that all that is needed to supply man’s every necessity is intelligent
direction and adjustment of the machinery.
Man cannot create force — it eternally exists. Man can direct
force for his benefit or pleasure just in the degree that he obtains
knowledge of the nature and qualities of force.
Certainly the human body is fearfully and wonderfully made.
Children, when they reach the age of comprehension, should be
taught the great importance and tlie wonderful working of their
internal machinery, or in other words the use of their lungs, stomach,
WONDERS OF THE HUMAN BODY.
14 c
liver, and kidne)'^s, that they make proper use of them, thereby pre-
serving their health, and growing to be strong men and women.
It is never too late to learn, and if you do not thoroughly under-
stand your ‘'internal machinery,” you should certainly do so.
In the first place your external body should receive proper care.
This is absolutely necessary and is the first law of health.
A sponge bath should be taken every morning; this opens the pores
of the skin and allows it to throw off the poison which accumulates
through the pores every twenty-four hours.
After you bathe, exercise your lungs by deep breathing. To do
this, extend the hands straight in front of you, bringing them up
over your head, at the same time taking a long deep breath; let the
air out of your lungs slowly, as you lower your arms to your sides.
Do this several times, as the average person is apt to acquire the
habit of drawing the air very little into the lungs, but the fresh air
should be drawn in full; way to the lower part or base of the lungs,
for the blood receives the oxygen (which gives life to the blood)
from the air, and to feed the blood properly, deep-drawn breaths
should be taken frequently.
After this exercise drink a glass of pure fresh water, this will give
you an appetite for breakfast, and before you sit down to the table
just bear in mind that food is something like your coal-bin, and
your stomach like your stove.
If you want a good fire in your stove you must put into it good
clean wood and good coal, free from rubbish ; therefore, put into your
stomach proper food in a proper way, that your stomach may take
good care of it, making good blood which is vitality.
Eat ripe fruit, good meat, oatmeal, eggs, etc., but never hot or
soggy bread, and do not drink water with your meals; one cup of tea
or coffee may be taken, but no more. Chew your food slowly and
well; this causes the flow of saliva from the glands in the mouth and
throat and sends the food to your stomach in proper condition for
stomach and liver to take care of it.
The “liver” is the most wonderful organ of the body. All the
corpuscles (solid particles in the blood) die every six weeks and
have to be disposed of ; the liver does most of this work, by grinding
them up and working them over into something of use.
The red corpuscles have potash in them, which makes bile; this
bile is a kind of lye which is a disinfectant; this passes into the
small intestines and should destroy all the poisonous germs in the
food before it passes into the blood.
If the liver does not do the work as it should the dead matter
accumulates in the body instead of being discharged through the
bowels, kidneys, and pores of the skin.
The liver, is a closed door which keeps poisons out of the body.
The kidneys, skin, and lungs are open doors to let the poison escape
14d
WONDERS OF THE HUMAN BODY.
from the body. When there comes such a pressure upon the liver
from over-eating or too rich or poor food, it cannot keep the poison
out, but lets it pass into the blood, so it is not purified.
This causes biliousness, a dull brain, yellow skin, dull eyes, the
poison gets into the muscles, they become flabby and you feel weary
and worn out. It gets into the nerves, causing sleeplessness, sciatica,
and all nervous diseases. All the food taken into the stomach is
filtered by the liver before it is absorbed. AU impurities in food, and
such as are in poor whiskey and tobacco, are filtered by the liver before
passing into the general circulation; for instance, if whiskey when
drank could immediately go to the brain without first being filtered
through the liver, the drinker would fall dead soon after taking it.
A healthy liver full of '‘glycogen” (animal starch) made from the
blood will destroy all poisons, but a poor and abused liver cannot
do this; therefore, look well to your liver and keep it strong and
healthful by good nourishing food, well cooked, well chewed, and at
regular times of day for your meals.
The kidneys, as we said before, are one of the open doors through
which part of the dead matter filtered through the liver is thrown out
of the body through the urine (water) ; therefore keep the kidneys well
flushed with pure water, drunk between meals, never with the meals.
Every person should drink at least six glasses of water every 24 hours.
The bowels are the other open door through which the bulk of the
waste matter passes from the body. They should be kept clear at
regular intervals; the best time is in the morning immediately after
breakfast.
As about nine tenths of the diseases flesh is heir to are caused
by ignorant or wilful abuse of the stomach and liver, every person
should make it their business to study themselves, their habits and
appetites; and if VTong, correct them as far as possible, for good
health is far better than riches.
We advise you to read carefully the chapter in this book on Anat-
omy and on Hygiene; it will help you to keep yourself and family
well, and we cannot urge you too strenuously to study this book and
make yourself familiar with it, so when sickness comes, as it surely
will, you will find these articles on different diseases, which are all
written by practicing physicians and specialists, will enable you to
diagnose the case almost immediately, often saving long and pro-
tracted sickness and perhaps a cherished life.
We have scores of letters from fathers and mothers, even from
physicians (who are strangers to us) from all parts of the country^
speaking in the highest terms of this book and thanking us for the
valuable advice and information received from it.
Therefore, study it; you will find it the best friend you ever had
and sometime we believe you will, say as many others do, "It’s worth
its weight in gold.”
ANATOMY
Unotu
Every person should know themselves physically; therefore read
carefully the following: chapters — first, on Anatomy; second,
on Hygiene — which are not only instructive, but
interesting, and will assist very materially
in avoiding and preventing disease.
ANATOMY,
Anatomy describes tbe structure and organization of living be-
ings.
Special Anatomy treats of the weight, size, shape, color, etc., of
each organ separately.
General Anatomy investigates the tissues or structures from which
organs are formed.
Surgical Anatomy or Regional Anatomy considers the relations of
organs to one another.
Physiological Anatomy treats of the uses or functions of organs in
health.
Pathological Anatomy describes the alterations made upon dif-
ferent organs by disease.
We shall here introduce a very brief compendium only of Special
Anatomy.
It is of great consequence that every person should have some
knowledge of anatomy and physiology. Self-knowledge ought to
extend to the body as well as the mind. To know one’s self, physi-
cally, is to gain a new insight into that wonderfully skilful adjust-
ment of means to ends which is never absent from the works of God.
Without tills knowledge, one cannot know how to take care of the
health ; and without health, life loses most of its value.
Structure of the Body.
The human body is composed of solids and fluids.
The fluids are most abundant in children and youth. It is this
wliich gives softness and pliancy to their flesh. In old age the fluids
are less abundant, and the flesh is more hard and wrinkled.
The fluids contain the whole body, as it were, in a state of solu-
tion ; or rather, they hold the materials out of which it is manufac-
tured.
Chemical Properties of the Body.
The four elements, oxygen, hydrogen, carbon, and nitrogen, make
up nearly the whole bulk of the fluids and soft solids of the human
body. A number of other elements, chiefly in a state of combina-
tion, and in much smaller quantities, enter into several of the tissues.
Binary Compounds. — Thus, we have carbonic acid in blood, urine
and sweat ; and we have water universally diffused through the sys-
tem, — each of these substances being a binary compound, that is,
composed of two elements.
Compounds of more than two Element.? are widely distributed
over the body ; as.
1(5
ANATOMY,
17
Carbonate of Soda in serum, saliva, bile, mucus, sweat, and tears.
Carbonate of Lime in cartilage, bone, and teeth.
Phosphate of Lime in bones, teeth, and cartilage.
Phosphate of Iron in blood, gastric juice, and urine.
Chloride of Sodium in blood, brain, muscle, bone, cartilage and
pigment.
Chloride of Potassium in blood, gastric juice, milk, and saliva.
Chloride -of Calcium in gastric juice.
Sulphate of Potassa in urine, gastric juice, and cartilage.
Sulphate of Soda in sweat, bile, and cartilage.
Sulphate of Lime in bile, hair, and scarf-skin.
Oxide of Iron in blood, black pigment, and hair.
Organized Compounds. — Besides the above inorganic elements
and compounds, several organized substances, or proximate elements, as
they are called, exist largely in the body. The chief of these are
albumen, fibrin, gelatin, mucus, fat, and casein. Others need not be
named.
Albumen is found in great abundance in the human body. It is
the raw material out of which the fiesh and other tissues are made.
The white of an egg, which is nearly pure albumen, is a good speci-
men of it.
Fibrin, when removed from the human body, changes from a solu-
ble to an insoluble state. In other words, it coagulates in a kind of
net-work. Nearly the same thing takes place constantly in the living
body, when the liquid fibrin leaves its soluble state, and is deposited
as solid flesh. Fibrin bears the same relation to albumen that wool-
len yarn does to wool ; it is spun from it in the busy wheel of or-
ganic life. And the flesh or muscle is related to fibrin as the cloth
is to yarn ; it is woven from it in the vital loom. Fibrin has been
called liquid flesh.
Gelatin exists largely in the ligaments, cartilages, bones, skin, and
cellular tissue. When dissolved, five parts in one hundred of hot
water, it forms a thick jelly. Isinglass is a form of gelatin obtained
from the air-bladder of the sturgeon and the codfish. Glue is still
another form of gelatin. It is extracted from the bones, and parings
of hides, and the hoofs and ears of cattle, by boiling in water. Black
silk, varnished over with a solution of gelatin, forms court-plaster.
Mucus is a sticky fluid secreted by the gland-cells. It is spread
over the surface of the mucous membranes, and serves to moisten and
defend them from injury.
Fat consists of cells held together by cellular tissue and vessels,
and contains glycerin, stearic acid, margaric acid, and oleic acid. It
has no nitrogen. If the stearic acid be in excess, the fat is hard ; if
the oleic acid preponderate, it is soft. The stearine extracted from
fat is used for making very hard candles.
18
ANATOMY.
Casein is abundant in milk and constitutes its curd. It is held
in solution in milk by a little soda. When dried, it is cheese. It is
found in blood, saliva, bile, and the lens of the eye. It forms the
chief nourishment of those young animals which live on milk. It is
found in peas, beans, and lentils. Vegetable and animal casein are
precisely alike in all their properties. Fibrin and albumen contain
almost exactly the same amount of oxygen, hydrogen, carbon, nitro-
gen, and sulphur, which is found in casein. This latter, when taken
into the stomach, therefore, goes, without much change, to the forma-
tion of the albumen and fibrin of the body.
Physical Properties of the Body.
The Tissues. — The solid organized substances of which the human
body is composed, are called tissues. There are various kinds of tissues.
The Cellular Tissue, commonly called areolar, is made up of small
fibres and bands woven together into a sort of net-work, with numer-
ous little spaces opening into each other. These spaces are filled with
a watery fluid ; and when tliis is greatly increased by disease, so as
to cause the parts to swell, and the skin to shine, the person has ana-
sarca, or cell-dropsy. The uses of this tissue are to give parts and
organs a kind of elastic cushion to rest upon, so that they may not be
bruised and injured by the shocks of life ; to make a kind of safe
highway for delicate vessels to pass from one part of the body to
another ; and to furnish a beautifully arranged lodgment for the wa-
tery fluid which gives such roundness, smoothness, and grace to the
human form. The opening of the cells into each other explains the
reason why feeble persons have swelled feet and ankles in the even-
ing, and not in the morning — the fluid settling down from cell to cell,
into the lowest parts, while they are up during the day, and running
back to its proper place while they are lying down during the night.
The Mucous Tissue, or mucous membrane, lines all the cavities
which communicate with the air, as the mouth, stomach, bowels, lungs,
etc. It is supplied with numerous small glands which secrete a
sticky kind of fluid called mucus, to protect the surface from any
injury which might be inflicted by air, or by irritating substances
suspended in it.
The Serous Tissue, or membrane, lines all the cavities which do not
communicate with the air, that is, all those which are shut, and have
no outward opening. The skull, the chest, and the belly are lined by
this kind of membrane. The membrane itself forms a closed sac,
— one layer of it being attached to the cavity it lines, while the other
is folded back upon and around the contents of the cavity, which are
left outside of the sac. A watery fluid oozes from the inner surface
of the sac, to make its sides glide easily upon each other. When
some disease causes this water to be poured out too freely, so as to
fill or partly fill the cavity, we have dropsy of the brain, or chest, or
abdomen, as the case may be.
ANATOMY.
19
The Dermoid Tissue covers the whole outside of the body. We
call it the skin, or cutis. It is similiar in structure to the mucous
membranes, which are a mere continuation of it. It is harder than
the mucous membrane, because more exposed to injury. In health,
it never ceases to secrete and throw off a fluid which we call insen-
sible perspiration while it is in the form of an invisible vapor, and
perspiration, or sweat, when it is so increased as to be seen. So
great is the sympathy between this dermoid covering of the body
and the mucous membranes, that when it is chilled so as to stop the
invisible perspiration, the internal membrane becomes affected, and
we have a sore throat, or diarrhoea, or running at the nose ; that is
to say, when the skin cannot sweat, the mucous membrane begins to
sweat.
The Fibrous Tissue consists of closely united fibres, and for what-
ever purpose used, forms a fine, dense, and enduring body. In some
cases it takes the form of a membrane, as the dura mater, which lines
the interior of the skull and spinal column. The ligaments which
hold the bones together, and the tendons or cords, which fasten the
muscles to the bones, are fibrous bodies. It is this firm substance of
which rheumatism frequently takes hold, and this is the reason why
it lingers so much about the joints. It sometimes takes hold of the
ligament which fastens the deltoid muscle to the bone of the upper
arm, about two-thirds of the way from the elbow to the shoulder.
This muscle lifts up the arm. In this form of rheumatism, therefore,
the arm hangs helpless at the side.
The Cartilaginous Tissue covers the ends of the bones where they
come together to make a joint. It is well fitted to make the joint
work easy, being smooth, hard, and elastic.
The Osseous or Bony Tissue varies in its composition, density,
and strength, according to the age of the person, and the uses of the
bone.
The Muscular Tissue, or muscle, being made for a great deal of
pulling and lifting, is formed something like a rope, except that
there is no twisting. Many small
fibres or filaments unite to form
fasciculi. A fasciculus is a bundle
of fibres surrounded by a delicate
layer of cell-tissue called sarcolemma,
— just as a cord is a number of
smaller threads of cotton or hemp
bound together. A number of these
fasciculi united together make a
muscle, — just as several cords, called
strands, twisted together, make a fiq. l
rope. Figure 1 gives us a good view of the fibres and bundles,
highly magnified.
20
ANATOMY.
The Adipose Tissue is tlie material which the human body works
up into pots and cells containing It is found chiefly under the
skin and muscles of the belly, and around the heart and kidneys.
By the increase of tliis tissue, persons may become enormously en-
larged without having their muscles at all increased in size. Such a
condition is to be deplored, — the body having become merely the
storehouse or depot of myriads of pots of fat.
The Nervous Tissue is composed of two distinct kinds of matter,
— the one gray and pulpy, called cineritious^ the other white and
fibrous, called medullary. The external part of the brain and the in-
ternal portion of the spinal cord are composed of the gray or ash-
colored tissue ; the nerves are made only of the white or fibrous
matter, and are inclosed in a delicate sheath called neurilemma.
Vital Properties of the Body.
Bodies begin their growth with a simple cell., which is a delicate
little bladder or shut sac. Cells take their rise in that portion of
the blood which is capable of being organized, and which is called
blastema.
In animal bodies each cell generally begins as a minute point in
the blastema, and grows until a transparent bladder or vesicle springs
out from one side of it, and soon appears to enclose it. The bladder
is then called the cell, and the point or dot is its nucleus. Within
this nucleus appears another dot, wluch is called the nucleolus.
When fully ripened, the cell bursts and sets the nucleus free, and
this, in its turn, matures and yields up its contents. Thus all cells
have their origin in germs produced by previously existing parent-
cells. They are multiplied with great rapidity. Having grown to
a certain extent, they lose their fluid contents, and their walls col-
lapsing or coming together, they form simple membraneous discs.
In this way, with some variations, the simple tissvies of the body be-
gin to be, and the foundation is laid for the noble structure of man.
Anatomy of the Bones.
The human skeleton is composed of two hundred and eight bones,
the teeth not included.
When fastened together by natural ligaments, the bones are said
to form a natural sk^h*^; when attached by wires, an artificial skele-
ton.
In Figure 2, — 1, 1, represent the spinal column ; 2, the skull ; 3,
the lower jaw ; 4, the breast-bone (sternum) ; 6, the ribs ; 7, the col-
lar-bone ; 8, the bone of the upper arm (humerus) ; 9, the shoulder-
joint; 10, the radius; 11, the ulna; 12, the elbow-joint; 13, the
wrist; 14, the hand; 15, the haunch-bone; 16, the sacrum; 17, the
hip-joint ; 18, the thigh-bone ; 19, the knee-cap (patella) ; 20, the
knee-joint ; 21, the fibula ; 22, the tibia ; 23, ankle-joint ; 24, the
foot ; 27, 28, 29, th« tlxyaments of the shoulder, elbow, and wrist ••
3
22
ANATOMY.
30, the large artery of the arm; 31, the ligaments of tne hip-joint;
32, the large blood-vessels of the thigh ; 33, the artery of the leg ;
34, 35, 36, the ligaments of the knee-cap, knee, and ankle.
The protuberances or swellings in certain parts of the bones are
called processes, and are the points to which muscles and ligaments
are fastened.
The bones are supplied with nutritive vessels, and, like other parts
of the body, are formed from the blood. At first they are compara-
tively soft and cartilaginous. After a time, in the young animal,
they begin to change to bone at certain places, called points of ossifi-
cation. They are covered with a strong, fibrous membrane called the
periosteum. A somewhat similar covering upon the cartilages has
the name of perichondrium., and that which covers the skull is the
pericranium.
The bones are compounded of earthy and animal matter. From
the former — phosphate and carbonate of lime — they receive their
strength ; from the latter — cartilage — they derive their life.
Put a bone for a few days into diluted muriatic acid, — one part
of acid to six of water, — and the phosphate and carbonate of lime
will all be removed, while
the bone will remain the ^
same in shape. It will now
be comparatively soft, and
may be bent, or even tied
into a knot without break-
ing. Place a similar bone
in the fire for a few hours,
and it will also retain its
shape, but the cartilaginous
portion will be gone. It is
now brittle, and may be
The bones are divided into those of the head, thirty ; of the body,
fifty-four; of the upper limbs, sixty-four; and of the lower limbs,
sixty.
Fig. 3.
picked in pieces with the fingers.
Bones of the Head.
The bones of the head are divided into those of the slcull, the ear,
and the /ace.
The skull has eight bones. They are composed of two plates, one
above the other, with a porous partition between. These two plates
are capable of giving the brain very powerful protection against in-
jury, the outer one being fibrous and tough, — the inner one, hard
and glass-like, and hence called vitreous.
The middle layer has the name of diploe. Its spongy nature
deadens the jar from a blow inflicted upon the outer table. In early
life, when the bones are tender and yielding, this porous layer is not
needed, and is not found.
ANATOMY.
23
That the hones of the skull may not easily slip by each other, and
get out of place, they are dovetailed together in curious lines called
sutures. In advanced years, these gen-
erally close up, the bones uniting firmly
together. In early life they are quite
open, the firm bones not covering the
whole brain. The opening of the
coronal suture in childhood is called a
fontaneUe. It presents a soft place
upon the top of the head, where the
finger could be pressed down into the
brain. In Figure 4, — 1, 1, show the
coronal suture on the front and upper
part of the skull ; 2, the sagittal suture
on the top of the skull ; and 3, 3, the
lambdoidal suture, running down on
each side of the back part of the skull.
Figure 5 shows the skull-bones separated from each other at the
sutures : 1, the frontal bone ; 2, the parietal ; 2, the occipital : 4, the
temporal ; 5, the nasal ; 6, the malar ; 7, the superior maxillary ; 8,
the unguis ; 9, the in-
ferior maxillary. Ar-
nott has demonstrated
that the form of the
skull is the best possible
for sustaining wei
and resisting blows. The
summit of the head is a
complete arch, like that
of a bridge.
The ear has four
small bones, which aid
the sense of hearing.
The bones of the face
are fourteen in number.
They hold the soft parts
in place, and aid in
grinding the food.
Bones of the Trunk.
In the trunk there are twenty-four ribs ; twenty-four pieces in the
backbone or spinal column ; four bones in the pelvis and hips ; one
breast-bone, called sternum ; and a bone at the base of the tongue,
called os hyoides. They are so put together as to form two great
cavities, namely, the thorax or chest, and the abdomen or belly.
The ribs, connecting with the backbone behind and the breast-bone
in front, form the thorax, which contains the lungs and heart. Fig.
Fig. 4.
24
ANATOMY.
6 shows the natural form of the healthy chest : 1, is the spine ; 2, 2,
the collar-bones ; 3, 3, the seven upper, or true ribs ; 4, 4, the five
lower or false ribs ; 6, the breast-bone, to winch the true ribs are
united ; 6, the sword-shaped
cartilage which constitutes the
lower end of the breast-bone,
called ensiform cartilage; 7, 7,
the upper part of two lungs ; 8,
8, the right lung, seen between
the ribs ; 9, 9, the left lung ; 10,
10, the heart; 11, 11, the dia-
plu’agm, or midriff; 12, 12, the
liver ; 13, 13, the stomach, 14,
14, the second stomach, or
duodenum ; 15, the transverse
colon ; 16, the upper part of the
colon on right side; 17, upper
part of colon on left side.
Each piece of the spinal col-
umn is called a vertebra. Upon
every one of these are seven
projections, called processes — a part of which are for linking the
bones together, and the rest to furnish
attachments for the muscles of the back.
The projections are linked together in
such a way, that a continuous channel or
opening runs down through the whole,
in which is lodged the spinal cord, or
medulla spinalis. This nervous cord is
connected with the base of the brain, and
is a kind of continuation of it.
Between all the vertebrse are certain
cartilaginous cushions, which, when com-
pressed, spring back, like India rubber,
and thus protect the brain from being injuriously jarred by running,
leaping, or walking.
The pelvis has four bones :
the two nameless bones — in-
nominata., the sacrum, and the
coccyx. In the side of each of
the nameless bones is a deep,
smooth cavity, called the ace-
tabulum. Into this the round
head of the thigh-bone is nicely
fitted. When the bone is
tlirown out of this cavity, the
hip is said to be out of joint.
The sacrum took its name
Fig. 8.
ANATOMY.
25
from the fact that the heathens used to offer it in sacrifice. With
them, it was the sacred bone. The coccyx is the lower termination
of the backbone. These bones are represented in Fig. 8 : 1, 1, being
the innominata ; 2, the sacrum ; 3, the coccyx ; 4, 4, the acetabulum :
a, a, the pubic portion of the nameless bones ; d, the arch of the
pubes ; e, the union of the sacrum and the lower end of the spinal
column.
Bones of the Upper Extremities.
The shoulder-blade (scapula), the collar-bone (clavicle), the bone of
the upper arm (humerus), the two bones of the forearm (ulna and ra-
dius), the bones of the wrist (carpal bones), the bones of the
\ palms of the hand (metacarpal bones), the bones of the
thumb and fingers (phalanges), — these are the bones of
the upper limbs.
The collar-bone is fastened at one end to the breast-bone,
at the other end to the shoulder-blade. It keeps the shoul-
ders from dropping forward. Many persons allow it to fail
of this end by getting very much bent in early life. This
happens at school, when children are allowed to sit in a
stooping posture. In the French, a race re-
markable for a straight, upright figure, this
bone is said to be longer than in any other
people.
The shoulder-blade lies upon the upper part
of the back, forming the shoulder. It has a
shallow cavity (glenoid cavity), into which is
inserted the head of the upper arm-bone. Sev-
eral strong muscles are attached to the eleva-
tions of this bone, which keep it in its place,
and move it about as circumstances require.
The upper arm-bone has its round head fast-
ened in the glenoid cavity, by the strong capsular liga-
ment, forming a joint capable of a great number of move-
ments. At the elbow it is united with the ulna of the
fore-arm. It is a long, cylindrical bone, represented by
Fig. 9 : 1, is the shaft of the bone ; 2, the large, round ;
head which fits into the glenoid cavity; 3, the surface!
which unites with the ulna.
Of the two bones of the fore-arm, the ulna is on the inner side, and
unites with the humerus, making an excellent hinge-joint. The
other bone of the fore-arm, the radius, lies on the outside of the arm,
— on the same side with the thumb, — and unites, or articulates, as
we say, with the bones of the wrist. In Fig. 10 : 1, is the body of
the ulna ; 2, the shaft of the radius ; 4, the articulating surface, with
which the lower end of the humerus unites ; 5, the upper extremity
of the ulna, called the olecranon process, which forms the elbow-
joint; 6, the point where the ulna articulates with the wrist.
Pig. 9.
Fig. 10.
26
ANATOMY.
The eight bones of the wrist or carpus are ranged in two rows, and
being bound close together, do not admit of
very free motion. In Fig. 11 : s, is the scaphoid
bone ; L, the semilunar bone ; c, the cuneiform
bone ; P, the pisiform bone ; T, T, the trapezium
and trapezoid bones ; M, the os magnum ; u, the
cuneiform bone. The last four form the sec-
ond row of carpal bones. 11, 11, are the meta-
I carpal bones of the hand ; 2, 2, the first range
of the finger-bones ; 3, 3, the second range of
i finger-bones ; 4, 4, the third range of finger-
bones ; 5, 6, the bones of the thumb.
Of the five metacarpal bones, four are at-
tached below to the first range of the finger-
bones, and the other to the first bone of the
thumb, while the whole are united to the second
Fig. 11. range of the carpal bones above.
Bones of the Lower Extremities.
These are the thigh-hone (femur), the Tcnee-pan (patella), the sTiiur
bone (tibia), the small hone of the leg (fibula), the hones of the instep
(tarsal bones), the hones of the middle of the foot (meta-
tarsal bones), and the hones of the toes (phalanges).
The thigh-hone is the longest bone in the system. Its
head, which is large and round, fits admirably into the
cavity in the innominatum, called acetabulum, and forms
what is called a ball-and-socket joint. In Fig. 12 : 1, is
the shaft of the thigh-bone (femur) ; 2, is a projection
called the trochanter minor, to which some strong mus-
cles are attached; 3, is the head of the femur, which fits
into the acetabulum ; 5, is the external projection of the
femur, called the external condyle; 6, the internal con-
dyle ; 7, the surface which articulates with the tibia,
and on which the patella slides.
The knee-pan or knee-cap (patella) is placed on the
front of the knee, and being attached to the tendon of
the extensor muscles above, and to the tibia by a strong
ligament below, it acts as a pulley in lifting up the leg.
The shin-bone (tibia) is the largest of the two in the
lower leg, and is considerably enlarged at each end.
The small bone of the leg (fibula) lies on the out-
side, and is bound to the larger bone at both ends. Fig./
13 shows the two bones of the leg: 1, being the tibia;)
5, the fibula ; 8, the space between the two ; 6, the
junction of the tibia and fibula at the upper extrem-
ity ; 3, the internal ankle ; 4, the lower end of the tibia that unites
Fig. 12.
ANATOMY.
27
with one of the tarsal bones to form the ankle-joint ; 7, the upper
end of the tibia, which unites with the femur.
The instep (tarsus) has seven bones, which, like those of the
wrist, are so firmly bound together as to allow but a limited motion.
The metatarsal bones, corresponding with the palm of the hand, are
five in number, and unite at one end with the tarsal bones, and at
the other with the first range of the toe-bones.
The tarsal and metatarsal bones are put together in the form of
an arch, the spring of which, when the weight of the body descends
upon it in walking, prevents injury to the organs above. (Fig. 14.)
The phalanges have fourteen bones. The great toe has two ranges
Fig. 13.
of bones ; the other toes have three. Fig. 15 gives a view of the
upper surface of the bones of the foot : 1, is the surface of the as-
tragalus where it unites with the tibia ; 2, the body of the astragalus ;
3, the heel-bone (os calcis) ; 4, the scaphoid bone ; 6, 6, 7, the cune-
iform bones; 8, the cuboid; 9, 9, 9, the metatarsal bones; 10, the
first bone of the great toe ; 11, the second bone ; 12, 13, 14, three
ranges of bones forming the small toes.
The Joints.
That bones may be of any use, they must be jointed together.
Joints are of the greatest importance. It is necessary they should be
so constructed that there shall be no harsh grating of the bones upon
each other, and no injurious jars in walking, etc. To prevent these
things, a hard, smooth, and yet yielding, cushion-like substance is
28
ANATOMY.
required between them in joints. Such are the cartilages. Fig. 16
gives a specimen of these intervening cartilages. D, is the body of
a bone, at the end of
which is a socket ; C,
the cartilage lining the
socket, thin at the sides
and thick in the centre ;
B, the body of a bone, at
the end of which is a
round head ; C, the investing cartilage, thin at the sides and thick
in the centre.
Cartilage grows thinner, harder, and less elastic in old age. Hence
old people are not quite as tall as in middle life, and a little stiff er
in their joints.
The synovial membrane is a thin layer covering the cartilage, and
being bent back upon the inner surface of the ligaments, it forms a
closed sac. From its inner surface a sticky fluid oozes out, which
helps the joints to play easily.
There are other smaller sacs connected with the joints, called
bursa mucosae. They secrete a fluid similar to that from the syno-
vial membrane.
Fig. 16.
The ligaments. To retain the bones in their places at the joints,
some strong, flexible straps are required to stretch across from one
to the other, and to firmly unite them. Such are the ligaments.
They are the pearl-colored, lustrous, shining parts about the joints,
in the form of straps and cords. There are a number of them so
woven together as to form a complete covering of the joint, called a
capsular ligament. In Fig. 17 : 1, 2, are ligaments extending from
the hip-bone, 6, to the femur, 4. In Fig. 18; 1, is the socket of the
hip-joint; 2, head of the femur, lodged in the socket; 3, the ligament
within the socket. In Fig. 19: 1, is the tendon of the muscle which
extends the leg ; 2, the knee-cap (patella) ; 3, the anterior ligament
PI. 8.
MUSCLES OF THE HUMAN BODY,
ANATOMY.
29
of the patella ; 6, the long external lateral ligament ; 4, 4, the syno-
vial membrane ; 5, the internal lateral ligament ; 7, the anterior and
superior ligament that unites the tibia with the fibula.
Uses of the Bones.
The bones are to the body what the frame is to the house. They
hold up and retain the other parts in their proper places. They fur-
nish points of attachment for the muscles, to hold the body together
and to give it motion. They also furnish strong, bony cavities for
the lodgment and protection of such delicate organs as the eye, the
brain, and the heart.
A single bone, examined by itself, might not seem to have much
beauty or design about it; it might even look clumsy and misshapen.
But when all the bones are inspected with reference to each other,
we immediately discover a general plan upon which they are made,
and are compelled to admire their beautiful harmony, and the sym-
metrical grace with which they act. They show us that God can
command our wonder, even in the bony frame of our bodies.
The iTuscles.
That part of the animal’s body which we call lean meat is com-
posed of muscles. We have already explained that muscles are com-
posed of threads, etc., put together in great numbers, forming bundles.
So numerous are these threads and bundles in some cases, that the
muscles which are composed of them have a strength truly wonderful.
Toward the end of the muscle, the fibres cease, and the structure
is so modified as to become a white cord of great density and strength.
This cordy substance is fastened to the bone so strongly, that it is
impossible, except in some rare cases, to detach it. Generally the
bone will sooner break than this attachment will give way. Some-
times this cord spreads out like a membrane. It is then called /asa'a
or aponeurosis.
The fibres of a muscle have the peculiar property of contracting
under a nervous stimulus sent to them by the will. These contrac-
tions cause them to act as pulleys, and to move the bones, and conse-
quently the limbs and body, in such direction as the will commands.
This is the special use of the muscles. All our movements are caused
by them. They pull us about, not blindly and at a random, but
under the direction of an intelligent will.
The manner in which a muscle acts, with the cord attached, may
be seen by examining the leg or “ drum-stick ” of a fowl. If the cord
on one side be pulled, the claws are shut; if that upon the other
side be drawn, they will open. If both be pulled, they are held fast
in one position, neither opening nor shutting.
An examination of a piece of boiled lean meat will show the
30
ANATOMY.
threads of which it is composed. With proper instruments, these may
be unravelled, as it were, until fibres will be found not larger than a
spider’s web. These, covered with sheaths of great delicacy, extend
beyond the fleshy fibre, and with the cell-substance connecting the
fibres, are condensed into tendon.
Millions of these sheathed fibres are gathered into a bundle, and
covered with a sheath, and thus form what is called a fasciculus. A
muscle is a number of these fascicula made into a bundle, and cov-
ered with a sheath called & fascia (Fig. 1).
The arm is a number of muscles bundled together, and covered,
likewise, by a fascia.
The fibres in a fasciculus being parallel, act together. But the
fasciculous bundles which make up a muscle act in various ways.
Shape of the Muscles Some muscles are fusiform or spindle-
— shaped, so that the attachment occupies but a
" small space (Fig. 20).
FIG. 20. Other muscles are radiate or fan-shaped (Fig.
21). Such is the temporal muscle, the thin
edge of which is attached to the side of the head,
without producing an elevation or deformity.
In some cases the fasciculi are arranged unon
one or both sides of a tendon. In this way a
great number may concentrate their action upon
a single point. Such muscles are called penni-
form, — being shaped like a feather (Fig. 22).
In other instances, the fasciculi form circular
muscles, — orbiculares, or sphincters, as
they are called. These surround certain openings into the
body, which they are designed to close, either in whole or
in part. They surround the eyelids, the anus, the mouth fio. 23.
of the womb, etc. (Fig. 23).
In still other instances the fasciculi are ranged side by side in
rings, forming muscular
tubes. By the successive
contraction of these rings,
any substance is driven
through the tube, — as food or drink through the gullet of a cow.
Fig. 24 is a section of the gullet : a, b, show the circular fibres ;
c, the longitudinal.
Sometimes the fasciculi curve around in parallel layers or inter-
lace with each other, forming a bag or pouch. By the contraction
of these fasciculi, the contents of the bag will be turned from side
to side as in the case of the stomach, or driven out, as in that of the
heart. Fig. 25 shows the muscles of the stomach : L, represents the
fibres running in one direction ; c, in another ; E, lower end of gullet
o, pylorus ; D, beginning of duodenum, or second stomach.
Fig. 24.
Fig. 22.
Fig 21
Brachialis-LiJ
anticus
.Rectus, .
abdominis
■External
obUcjue
1.= — Tensor fasciae
I femoris
^ — Pectineus
__ . . Sterna - deldd^ mastoid
Trapezius
- - - -Deltoid (or shoulder)
-—Pedorah's major
^..Extensor carpi
‘ radial IS
Extensor' .
communis
digitorum
Flexor carpi —
umans
flexor carpi-.
radiah's
Biceps i
{or front arnf
Triceps
(or back arm)
Laiissimus dors!
Serratus majnus
Sartonus
Rectus femons
-Adductor hnqus
Mastus externus
Vastus mternus
Patella (or knee pan)
Tibia (or shm bone)-
flnnu/ar Ligament
i— Gastrocnemius (or calf)
- Tibialis anticus
... Flexor hn^us di^itorum
- -—-Extensor lon^us dijiforum
The Muscles of the Human Body.
COPYRIGHT 190S.
PHYSICIANS PUBLISHING CO., BOSTON, MASS,
I
Sterno -fnastoid
Sp/emus capitis
Trapezius ■"
Triceps
Txtensor carp! _
radial is long tor
Extensor carpi
radiaUs breviorr
Extensor communis
di^itorum
Gluteus rnedius — ''
Biceps
Semi- tenJinosus - ■
Semi -membranosus
Supinator
lor.^us
Posterior portion of external oblhjue
- Triceps
Deltoid
Teres minor
Teres major
Infraspinatus
Latissimus dorsi
— Gluteus maximus
Vastus externus
$oleus—{_
_)-• Gastrocnemius
Tendon achillis
The Muscles of the Human Body.
COPYRIGHT 190&*.
PHYSICIANS PUBLISHING CO., BOSTON, MASS.
ANATOMY.
33
Number of Muscles. — The muscles of the body are as numerous
as the ropes of a ship, — there being five hundred or more. Some
anatomists reckon more, some less.
They are divided into those of the head and nech^ those of the
trunk, those of the upper extremities, and those of the lower extremi<
ties.
They are too numerous to be named and individually described in
this brief account of them. A part of them are voluntary, that is,
under the control of the will ;
while another part are involun-
tary, moving without reference to
the will. The heart is of the
latter kind, it being necessary for
it to keep moving when the will
and mind are asleep.
On the back there are six
layers of muscles, one above an-
other. Such a number are neces-
sary to perform the numerous
movements of the back, neck,
arms, etc. Every expression of the human face, as joy, sorrow, love,
hate, hope, fear, etc., is produced by the gentle pulling of muscles,
made expressly to indicate these emotions.
The diaphragm is a large fiat muscle, reaching across the great
cavity of the body, and dividing the chest from the abdomen. It is
penetrated by the gullet going to the stomach, and by the great
blood-vessels leading to and from the heart. It is shaped like the
cover of a dinner-dish, the convex surface being turned up. When
the breath is drawn in, it sinks down towards a level, thus enlarging
the chest at the expense of the belly. When the breath is thrown
out, the reverse takes place.
Mode of Action. — The contractibility of a muscle, of which I have
spoken, is simply its power of shortening itself. The hand is raised
by the shortening of a mus-
cle in front, attaehed to the
bone above the elbow, and
to a bone below the elbow.
The contraction of an an-
tagonistic muscle behind,
also attached above and be-
low the elbow, brings the
hand back to its place. Fig.
26 shows how all joints are
moved : 1, is the bone of the arm above the elbow ; 2, one of the
bones below the elbow; 3, the muscle which bends the elbow; 4, 5,
attachments of museles to bones ; 6, the muscle that extends the
34
ANATOMY.
elbow; 7, attachment to elbow; 8, weight in hand. The muscle, 8,
contracts at the eentral part, and brings the hand up to 9, 10.
The complication, variety, and swiftness of motion, executed by
muscles, are past eonception. Every movement which a human be-
ing makes, from the heavier motions of the farmer in cultivating his
fields, up to the magic touches of the painter’s brush, and the method-
ical frenzy with which the great master’s fingers sweep the piano, are
all made by muscles obeying an intelligent will.
The Teeth.
The teeth are not like other bones, either in composition, method
of nutrition, or growth. When broken they do not unite, not being
furnished with the neeessary power of reproduction of lost parts.
Both the upper and lower teeth are set into bony sockets, called
alveolar processes. These, with the fibrous gums, give the teeth a
very firm setting.
Origin. — The teeth have their origin in little membranous
pouehes within the bone of the jaw, which, in their interior, have a
fleshy bud. From the surface of this the bone or ivory exudes. The
tooth and the bony socket are developed and rise up together, — the
former, when sufficiently long, pushing itself through the gum.
Number. — The first set of teeth are only temporary, and are called
milk-teeth. There are but twenty of them. Between the age of six
and fourteen, these become loose, and drop out, and the permanent
teeth appear in their places. Of these there are thirty-two, sixteen
in each jaw.
Names The four front teeth in each jaw, a, h. Fig. 27, are the
cutting teeth (incisors) ; the next one, c, is an eye-tooth (euspid) ; the
Fig. 27.
next two, d, e, are small grinders (bicuspids) ; the last three, /, A,
are grinders (molars). One appears late on each side, from the age
of twenty to twenty-four, and is called wisdom tooth.
ANATOMY.
35
Composition. — A tooth is composed of ivory and enamel. The
internal part is ivory, which is harder than bone. The coating upon
the surface is enamel, which is still harder than ivory. That part
which rises above the jaw-bone is called the crown ; it is this only
which is covered with enamel. The part within the jaw is called the
root or fang ; this is composed of bony matter, through which small
vessels pass in to nourish the tooth. Small white nerves also pass
into the tooth, — of the presence of which we have terrible evidence
in tooth-ache.
Use of the Teeth.
The incisors cut the food asunder; the molars break down its
solid parts, and grind it to a fineness which fits it for the stomach.
In masticating the food, the lower jaw has two movements, the up-
and-down motion, like a pair of shears, and the lateral or grinding
motion. These two movements are performed by different sets of
muscles. Flesh-eating animals have only the up-and-down motion ;
vegetable-eating animals have only the lateral or grinding motion ;
while man has both the up-and-down and the lateral. This seems
a pretty clear intimation that he is to eat both flesh and vegetables.
The teeth aid us in articulating words, and they give a roundness
and symmetry to the lower part of the face. When well formed, and
kept in good condition, they add much to the beauty of the face, and
their decay is an irreparable loss. Their proper care and treatment
are spoken of in another place.
The Digestive Organs.
The alimentary organs are the mouth, the teeth, the salivary glands,
the pharynx, the gullet (oesophagus), stomach, bowels (intestines),
chyle vessels (lacteals), thoracic duct, liver and sweetbread (pan-
creas).
The preparatory process of digestion, the mastication of food,
takes place in the mouth, where the food is mixed with saliva, a se-
cretion of the salivary glands. Of these glands there are six, three
on each side. .
The Parotid QIand lies in front of the external ear. It has a duct
opening into the mouth opposite the second molar tooth of the upper
jaw. This is the gland that swells in the disease called mumps.
Hence the disease is also called parotitis.
The Submaxillary Gland is inclosed within the lower jaw, in front
of its angle. Its duct opens into the mouth by the side of the bridle
of the tongue (froenum linguae).
On each side of this string or bridle, and under the mucous mem.-
brane of the floor of the mouth, lies the sublingual gland, which
pours its saliva into the mouth, through seven or eight small ducts
36
ANATOMY.
A disease called the frog consists in the swelling of this gland.
Fig. 28: 1, the parotid gland; 2, its duct; 3, the submaxillary;
4, its duct ; 5, the sublin-
gual.
The Pharynx is a con-
tinuation of the mouth, and
is the cavity just below the
soft palate. The two pas-
sages going to the nose
(posterior nares), the one
going to the stomach
(oesophagus), and the one
going to the lungs (larynx
and trachea ; all meet in
this cavity. In Fig. 29:
1, is the trachea ; 2, the
larynx ; 3, the oesophagus ;
4, 4, 4, muscles of pharynx ; 5, muscles of the cheek ; 6, the muscle
which surrounds the mouth ; 7, the mus-
cle forming the floor of the mouth.
The QuUet or oesophagus is a long tube,
descending behind the windpipe, the
lungs, and the heart, through the dia-
phragm into the stomach. It is composed
of two membranes laid together, like two
pieces of cloth. The inner one is mucous,
the outer muscular. The two sets of
fibres composing the muscular coat are
arranged circularly and longitudinally
(Fig. 25).
The Stomach lies in the upper part of
the belly, to the left, and directly under
the diaphragm. It has an upper opening,
where the stomach-pipe enters it, called
the cardiac orifice. This is the larger end of the stomach, and lies
on the left side ; the smaller end connects with the upper bowel, at
which point it has an opening called the pyloric orifice. In addition
to mucous and muscular coats, similar to those which compose the
oesophagus, the stomach has still another over both, a serous coat,
very strong and tough, to give this working organ additional en-
durance. Within, it has many glands to secrete the gastric juice.
Fig. 29.
The Intestines, or alimentary tube, or hoivels., are divided into the
small and large intestines.
The small intestine has a length of about twenty-five feet, and is
divided into three parts, — the duodenum,., the jejunum, and the ileum.
Of these three divisions, the duodenum is the largest, and is about
ANATOMY.
37
a foot in length. It begins at the pyloric orifice of the stomach, and
passes backward to the under surface of the liver, whence it drops
down perpendicularly in front of the right kidney, and passes across
the belly behind the colon, and ends in the jejunum.
The Jejunum continues the above, and terminates in the ileum.
The Ileum is a continuation of the, jejunum., and opens, at an obtuse
angle, near the haunch bone, into the colon. A valve is located here,
to prevent the backward passage of substances from the colon into
the ileum.
At this point the large intestines begin, and here is situated the
caecum., a blind pouch, or cul-de-sac, attached to which is the appen-
dix vermiformis, a worm-shaped tube, of the size of a goose-quill, and
from one to six inches long.
The Colon, or large intestine, is divided into the ascending colon, the
transverse colon, and the descending colon.
The Ascending Colon rises from the right haunch-bone to the under
surface of the liver, whence it bends inward, and crosses the upper
part of the belly, below the liver and stomach, to the left side. This
portion which crosses over is the transverse colon. From this point,
on the left side, it turns down to the left haunch, and has the name
of the descending colon. Here it makes a curve like the letter S,
which is called the sigmoid flexure.
TSie Rectum is the lower portion of the large intestine, terminat-
ing at the anus.
The Lacteals are small vessels which begin in the villi, upon the
mucous membrane of the small bowels. From here they pass be-
tween membranes of the mesentery to small
glands, from which larger vessels run to
another collection of glands; and after
passing, for a space, from one collection of
glands to another, at each stage of their
progress increased in size and diminished
in number, the lacteals pour their contents
into the thoracic duct. This having passed
up through the diaphragm, out of the
belly, makes a sudden turn downward and
forward, and empties its burden into a
large vein which ends in the right heart.
Fig. 30 : 1, is the bowel ; 2, 3, 4, the
mesenteric glands through which the lac-
teals pass ; 5, the thoracic duct ; 7, the spinal column ; 8, the
diaphragm.
By the help of a magnifying glass, an infinite number of these
small vessels may be seen starting from the rough, shaggy internal
coat of the bowel.
38
ANATOMY.
The mesentery is a thick sheet of membrane, formed of several
folds of the peritoneum, and spread out from the vertebrae like a fan.
The bowels are attached to its edge, and are held by it in their place,
and at the same time have free motion. Between its layers are a
great number of glands, which sometimes become diseased and swol-
len in childhood, and prevent the chyle from passing along to the
thoracic duct. Thus affected, children are not nourished, and waste
away with a disease sometimes called mesenteric consumption.
The Liver is a large gland, lying under the short ribs on thejight
side, below the diaphragm. It is convex on the upper surface and
concave on the under, and is
composed of several lobes. Its
office is to secrete bile. It
weighs about four pounds,
being the largest organ in the
body. Fig. 31 represents the
liver: 1, being the right lobe;
2, left lobe ; 3, 4, smaller lobes ;
10, gall-bladder ; 17, the notch
into which the spinal column
is fitted.
The GalLBladder lies on
the under side of the liver, and receives, it is supposed, the surplus
bile, which is reserved for special occasions. It opens into the gall-
duct, which carries the bile along, and pours it into the duodenum.
The Pancreas, Fig. 32, is a long, flat gland, something like the
salivary glands. It lies transversely across the back wall of the ab-
domen, behind the stomach.
It secretes a colorless, al-
kaline fluid called the 2^mir
creatic juice^ the office of
which is to emulsify the
different classes of food,
so that the lacteals can ab-
sorb it. This fluid is car-
ried by a duct, and poured into the duodenum just where the bile-
duct enters.
The Spleen has an oblong, flattened form. It lies on the left
side, just under the diaphragm, and close to the stomach and
pancreas. It is supposed to be a reservoir for holding the surplus
blood of the liver. It was thought by the ancients to be the seat of
melancholy. The blood in passing through it loses a portion of its
red globules.
The Omentum or caul is a doubling and extension of the perito-
neum. It is a kind of fatty body, which lies upon the surface of the
AITATOMY.
39
bowels and is attached to the stomach. Its use seems to be to lubri-
cate the bowels, and especially to protect and keep them warm.
Hence it is often called the apron.
The Urinary System.
The organs of this system are devoted to separating the urine from
the blood, and carrying it out of the body. These organs are the
Mdneys, the ureters., the bladder., and the urethra.
The Kidneys lie one on each side of the backbone, in the lumbar
region, behind the peritoneum. They are four or five inches long,
and two and a half broad. They are in shape like the kidney-bean,
and weigh about half a pound each. In the centre there is a bag
called the pelvis, which tapers like a funnel, and unites with the
ureter which conveys the urine to the bladder. The texture of the
kidney is dense, presenting in its interior two structures, an external
or cortical, and an internal or medullary. The cortical portion has
the blood-vessels, the medullary is composed of tubes which carrj
away the urine.
The Ureters are membranous tubes of the size of a goose-quill,
and eighteen inches long, which run down the back wall of the abdo-
men, behind the peritoneum, to the bladder, into each side of which
they empty their contents.
The Bladder is located in the pelvis, in front of the rectum. It is
composed of three coats ; the external is serous, the middle muscular,
and the internal mucous. The external coat is strong and fibrous ;
the internal is drawn into wrinkles, which makes it thick and shaggy;
it secretes a mucus which prevents it from being injured by the cor-
rosiveness of the urine. The urine is retained in the bladder by
means of a circular muscle, called a sphincter, which draws the mouth
of the organ together. When the quantity of urine is so increased
as to give some uneasiness or pain, this muscle, by a sort of instinct,
relaxes and lets it out.
The bladder is attached to the rectum, to the hip-bones, to the
peritoneum, and to the navel, by several ligaments. In the female
the bladder has the womb between it and the rectum.
This organ is wisely provided as a receptacle for the urine ; which,
without it, would produce a great inconvenience by being constantly
dribbling away.
The Urethra is a membranous canal which leads from the neck
of the bladder. It is composed of two layers, a mucous and an elas-
tic fibrous. Through this channel, which is curved in its course, the
urine passes out of the body.
40
ANATOMY.
The Respiratory Organs.
These organs consist of the windpipe (trachea) ; divisions and
subdivisions of the windpipe (bronchia) ; air-cells ; and the lungs or
lights.
The Windpipe (trachea) extends from the larynx — the seat of the
voice — to the third dorsal vertebra, where it divides into two tubes,
called bronchia. It runs down the front part of the throat, with the
oesophagus behind and between it and the spinal column. It is com-
posed mainly of rings of cartilage, one above another.
The Bronchial Tubes are, at the division of the windpipe, two in
number, but they divide and subdivide until they become very nu-
merous.
The Air-Cells or Vesicles are small, bladder-like expansions at the
ends of the tubes. They are elastic and swell out when the air
passes in.
The Lungs fill the greater part of the chest, the heart being the
only other organ which occupies much space in the cavity. The
size of these organs is large or small, according to the capacity of the
chest. Each lung — for there are two — is a kind of cone, with its
base resting upon the diaphragm, and its apex behind the collar-bone.
They are concave on the bottom, to fit the diaphragm, which is con-
vex on its upper side.
The right and left lungs are separated from each other by a parti-
tion called the mediastinum., formed by two portions of the pleura, a
smooth serous membrane coming off from the spine and closely en-
veloping each lung ; the heart, covered by the pericardium, lies
in the centre, between them. The right lung is divided into three
lobes ; the left into two.
Each lobe of the lungs is divided into a great many lobules, which
are connected by cellular tissue. These lobules are again divided
into very fine air-cells. Besides these, the substance of the lungs is
composed likewise of blood-vessels and lymphatics, and is well sup-
plied with nerves.
In the foetal state, before the lungs have been filled with air, they
are solid and heavy, sometliing like other flesh, but after all their
cells have been filled with air, and breathing has been established,
they are exceedingly light and spongy, and float upon water.
In cases where infanticide is suspected, and where it is desirable
to know whether the child was still-born, or born alive and killed
afterwards, the specific gravity of the lungs, compared with water,
will often settle the question.
ANATOMY.
41
The Organs of Circulation.
The food having been digested, changed to chyle, absorbed by the
lacteals, carried to the veins, poured into the right heart, sent up to
the lungs, and prepared for nourishing the body, will still be useless,
if not distributed to every part of the system. The organs for ef-
fecting this distribution are the heart, the arteries, the veins, and the
capillaries.
The Heart is placed obliquely in the chest, with one lung on each
side, and is enclosed between the two folds of the mediastinum Its
form is something like a cone. Its base is turned upward and back-
ward in the direction of the right shoulder; the apex forward and to
the left, occupying the space between the fifth and sixth ribs, about
three inches from the breast-bone. It is surrounded by a membranous
case or sac, called the pericardium.
The heart is a muscular body, and has its fibres so interwoven that
it is endowed with great strength. It is a double organ, having two
sides, a right and a left, which are divided from each other by a mus-
cular partition, called a septum. The right heart sends the blood to
the lungs ; the left heart distributes it to the general system. Each
side is ^vided into two compartments, an auricle and a ventricle.
The Auricles have thinner walls than the ventricles, being only
reservoirs to hold the blood until the ventricles force it along to other
parts.
The Ventricles have within them fleshy columns, called columnce
carnecB. The walls of the left ventricle are thicker than those of the
right, being required to contract with more force. Each of the four
cavities will contain from one and a half to two ounces of blood.
The Tricuspid valves are situated between the auricle and ventricle
on the right side, and consist of three folds of a thin, triangular
membrane. The mitral valves occupy the same position on the left
side. Small white cords, called chordae tendinoe,
pass from the floating edge of these to the
columnae carneae, to prevent the backward press-
ure of the blood from carr}dng the valves into
the auricles.
The pulmonary artery is the outlet of the
right ventricle ; the larger artery, called aorta,
of the left ventricle. At the opening of these
arteries are membranous folds, called semilunar
valves. Fig. 33 gives a fine view of the heart :
1, is the right auricle ; 2, the left auriele; 3, the
right ventricle; 4, the left ventricle; 5, 6, 7, 8,
9, 10, the vessels which bring the blood to and carry it away
the heart.
42
ANATOMY.
The Arteries are the round tubes which carry the red blood from
the left side of the heart to every part of the body.
The sides of arteries are stiff and hard, and do not fall together
when empty. They may often be seen open in a piece of boiled beef.
The arteries have three coats, — an external, which is cellular, firm
and strong ; a middle, which is fibrous and elastic ; and an internal,
which is serous and smooth, being a continuation of the lining of
the heart. They are siirrounded by a cell vestment called a sheath^
which separates them from surrounding organs.
The Pulmonary Artery starts from the right ventricle in front of
the opening of the aorta, and ascends to the under surface of the
aortic arch, where it parts into two branches, sending one to the right,
the other to the left lung. Having divided and subdivided to a great
extent, they end in the capillary vessels, uniting, joining their mouths,
and becoming continuous with the’ pulmonary veins just where they
pass around the air-cells.
The Aorta is the largest artery in the body. It takes a slight turn
in the chest, called the arch of the aorta^ from which are given off the
arteries which carry the blood to the head, etc. ; thence it descends
into the belly along the side of the backbone, and at the bottom of
the abdomen it divides into two arteries, called the iliacs — one going
to each of the lower limbs. The branches the aorta gives off a supply
of red blood to every part of the body.
The Veins carry the dark or purple blood. Being made red and
vital by meeting atmospheric air in the lungs, and then conveyed to
every part of the body in the arteries, the blood loses its redness in
the capillaries, and comes back to the heart in the veins, dark and
purple, and unfit to support life. The veins are more numerous and
nearer the surface than the arteries. They have, likewise, thinner
walls, and when empty, they collapse or fall together. They begin
in the small capillaries, and running together, they grow larger and
larger, and finally form the great trunks which pour the dark blood
into the right auricle. The veins are composed of three coats, simi-
lar to those of the arteries, with the exception of being thinner and
more delicate. These vessels have valves all along their inner sur-
face, to aid in circulating the blood.
The large vein which receives all the dark blood from above, and
pours it into the right auricle, is called the vena cava descendens ; the
one which takes it from below, and disposes of it in the same manner,
is the vena cava ascendens.
The pulmonary veins bring the red blood from the lungs to the left
auricle, and thus are exceptional in their use, — being the only veins
which carry red blood.
The Capillaries are the extremely fine network of vessels between
the ends of the arteries on the one side, and of the veins on the other.
ANATOMY,
43
They inosculate, or join their mouths to the very small arteries at
one end, and to the equally small veins at the other. They are the
industrious little builders of the human frame. Receiving the blood,
red, and full of life, from the terminal extremities of the arteries,
they take the living particles out of it, and apply them to the renewing
and vitalizing of the body, and then pass it along into the hair-like
beginnings of the veins, dark and bereft of vitality, to be carried up
for another freight of chyle, and to be again vitalized by being touched
in the lungs by the breath of heaven.
In Fig. 34 we have a good ideal illustration of the whole circu-
lation. From the right ventricle of the heart, 2, the dark blood is
thrown into the pulmonary ar-
tery, 3, and its branches, 4, 4,
carry it to both lungs. In the
capillary vessels, 6, 6, the blood
comes in contact with the air,
and becomes red and vitalized.
Thence it is returned to the left
auricle of the heart, 9, by the
veins, 7, 8. Thence it passes
into the left ventricle, 10. A
forcible contraction of this
sends it forward into the aorta,
11. Its branches, 12, 13, 13,
distribute it to all parts of the
body. The arteries terminate
in the capillaries, 14, 14. Here
the blood loses its redness, and
goes back to the right auricle,
1, by the vena cava descendens,
15, and the vena cava ascend-
ens, 16. The tricuspid valves,
17, prevent the reflow of the
blood from the right ventricle
to the right auricle. The semi-
lunar valves, 18, prevent the
blood from passing back from the pulmonary artery to the right
ventricle. The mitral valves, 19, prevent its being forced back from
the left ventricle to the left auricle. The semilunar valves, 20, pre-
vent the backward flow from the aorta to the left ventricle.
By a careful examination of this diagram, with these explanations,
the reader may understand the circulation very well.
The passage of the blood from the right heart, through the lungs,
and back to the left heart, is called the lesser, or pulmonic circulation ;
its passage from the left heart through all parts of the body, and back
to the right heart, is the greater or systematic circulation.
44
ANATOMY.
The Absorbent Vessels.
The vessels which absorb the chyle from the small intestines, and
convey it onward towards the blood, are the lacteals. They have
been described. The veins are also supposed to have the power of
absorption, particularly the small
commencements of the veins.
These have likewise been de-
scribed.
The Lymphatic vessels resemble the lacteals. They abound in the
skin, the mucous membranes,
and the lungs. They are
very small at their origin,
and, like the veins, they in-
crease in size, as they dimin-
ish in numbers. Like the
veins, too, they travel to-
wards the heart, and their
Fig. 36, Fig. 37.
contents are poured -into it.
Their walls are composed of
two coats ; the external is
cellular, and distensible ; the
internal is folded into valves,
like that of the veins.
These vessels, on their
way to the heart, pass
through soft bodies, called
lymphatic glands^ which bear
to them the relation that the
mesenteric glands do to the
Fig. 38.
ANATOMY.
45
lacteals. These glands are a collection of small vessels. The
lymphatic glands are most numerous in the neck, chest, abdomen,
arm-pits, and groins. They are also found, to some extent, in other
parts of the body. Fig. 35 shows a single lymphatic vessel, much
magnified ; Fig. 36 exhibits the valves along one of the lymphatic
trunks ; Fig. 37 shows *''a lymphatic gland with the vessels passing
through it.
Fig. 38jepresents the lymphatic vessels and glands. 1, 2, 3, 4, 6,
6, show these vessels of the lower limbs ; 7, the inguinal glands ; 8,
the commencement of the thoracic duct, into which the contents of
lymphatic are poured; 9, the lymphatics of the kidneys; 10, those
of the stomach; 11, those of the liver; 12, 12, those of the lungs ;
13, 14, 15, those of the arm; 16, 17, 18, those of the face and neck ;
19, 20, the large veins ; 21, the thoracic duct; 26, the lymphatics of
the heart.
A cold will often cause lymphatic glands to swell. These swell-
ings are ca,lled Tcernels. They often swell, also, without the irritation
from cold, and become very much and permanently enlarged, particu-
larly in scrofula. In scrofulous subjects they sometimes suppurate
and break, forming bad sores upon the neck.
The Organs of Secretion.
The exhalants, follicles, and the glands are the organs of secre-
tion.
The Exhalants are the sweat-glands. These have external termi-
nations upon the skin, thus communicating with the air, and internal
terminations upon the surfaces of organs not having an outward ex-
posure.
The Follicles are small sacs, located in the true skin and mucous
membranes. The pores of the skin are the mouths or outlets of these
little bags. Veins and organic nerves are sent to these vessels.
Glands are soft organs, having a variety of structure, and perform
ing many kinds of secretion. A gland is made up of several lobules,
united in one mass, and each of these lobules
has a small duct, communicating with a
main duct which forms the outlet. Fig. 39
shows a gland ; 2, the small ducts spread
through its body, and running together;
1 , the large duet, through which the secreted
substance is carried away.
The mesenteric and lymphatic glands
merely modify the fluids which pass through
them ; others secrete from the blood either
fluids to be used in the body, or such as are to be cast away.
46
ANATOMY.
The Vocal Organs.
No sounds touch the heart like those of the human voice, for no
mechanic, however scientific and skilful, has ever been able to make
an instrument which could produce sounds as beautiful, tones as
varied, a timbre as melodious, and inflexions as manifold and agree-
able. It has been compared to wind, reed and stringed instruments.
In touching expression, it is most resembled by the concert-horn, the
bassoon, and the hautboy.
Vocal sounds, past all question, are produced in the larnyx, but
these sounds are grouped, or formed into articulate speech, by the
pharynx, the nasal cavities, the tongue, the teeth, etc.
The Larynx is a kind of cavity or tube at the top of the windpipe,
formed by the union of five cartilages, namely, the thyroid, the cricoid,
the two arytenoid, and the epiglottis. Ligaments bind these together,
and muscles move them.
The Thyroid Cartilage is composed of two parts, and has a con-
nection with the bone of the tongue above, and with the cricoid car-
tilage below.
The Cricoid Cartilage is shaped like a ring, and hence its Greek
name. It is narrowest in front, and broadest behind. It connects
with the thyroid cartilage
above, and with the first ring
of the trachea below. Fig. 40
gives a side view of the car-
tilages of the larynx : 1, bone
at the base of the tongue (os
hyoides) : 2, the ligament con-
necting hyoid bone and the
thyroid cartilage ; 3, the front
of the thyroid cartilage ; 4, the
thyi'oid cartilage ; 6, the cri-
coid cartilage ; 7, the wind-
pipe.
Fig. 40. ^ back view of
the cartilages and ligaments of the larynx : 1, is the back surface
of the epiglottis ; 3, 3, the os hyoides ; 4, 4, the lateral ligaments
connecting the os hyoides and the thyroid cartilage ; 5, 6, the back
face of the thyroid cartilage ; 6, 6, the arytenoid cartilages ; 7, the
cricoid cartilage ; 8, the first ring of the windpipe.
The Arytenoid Cartilages are upon the back part of the cricoid,
and are connected with the thyi’oid cartilage by the vocal cords.
The Epiglottis is a fibro-cartilaginous lid, shaped like a leaf, wliich
covers the upper opening of the larynx. It is connected by a carti-
ANATOMY.
47
lage to the bone of the tongue (os hyoides) and to the thyroid carti-
lage. Breathing opens and shuts it ; and in swallowing, it closes
down upon the top of the larynx, to prevent food and drink from
passing down the windpipe.
The Vocal Cords are two ligaments, formed of elastic and parallel
fibres, enclosed in a fold of mucous membrane. They are about two
lines in width, and inserted behind into the t>
anterior projection of the arytenoid car-
tilages, and passing forward, are fixed to
the anterior angle of the thyroid. There
are four ligaments crossing the larynx,
two superior and two inferior, — the lat-
ter being called vocal cords. The interval
between them is the glottis. The liga-
ments themselves are sometimes called
the lips of the glottis. The depression be-
tween the superior and inferior ligaments
is the ventricle of the larynx.
Fig. 42 represents a view of the larynx
from above : a, b, e, the thyroid cartilage, enclosing the ring of the
cricoid ; h, h, e, e, the arytenoid cartilages connected by the trans-
verse arytenoid muscle ; i, i, the vocal cords ; o, o, the crico-arytenoid
ligaments.
The muscles which are attached to the cartilages have the power
of pillling them about so as to change in various ways the shape of
the larjmgeal cavity ; to enlarge or diminish the size of the glottis :
and to relax or tighten the vocal cords. By these means, and some
others, the sounds of the voice receive their various modifications.
Tightening the cords, for example, raises the pitch.
The Skin.
The skin is a membrane composed of two layers, covering the
entire person. The outer layer is the scarf-skin or cuticle ; the inner
is the true skin or cutis or corium. These layers differ in their struc-
ture and uses.
The Scarf-Skin, called also cuticle and epidermis, is a thin mem-
brane, partially transparent, like a thin shaving of horn. Having no
blood-vessels or nerves, and consequently no feeling, it appears to be
a simple covering to protect the true skin from injury by external
agents. It is thickest on those parts most exposed to friction.
The scarf-skin is the production of the true skin, — an exudation
from it in the shape of a fluid which is spread out as a thin layer,
and dries up into flattened scales. The cuticle is composed chiefly
of these scales, and is constantly being rubbed off as scurf, while
new layers are forming underneath.
48
ANATOMY.
The lower, softer layer of the scarf-skin, called the malpighian
layer, or rete mucosum, is the seat of color. In this part the cells
contain a pigment incorporated with the elementary granules, which
gives to the various races their several shades of color. The depth
of hue is dependent entirely on the amount of this coloring matter.
The True Skin, which is called cutis, derma or coriiim, is a Idnd of
web, woven of small fibres collected into strands. In the upper por-
tion, the web is fine and firm, but grows coarser below. Connected
Fig. 43.
e e «
Fig. 44.
with its under surface is a fibrous web in which the fat is deposited.
Upon its upper surface is the sensitive or papillary layer, composed
of blood-vessels and nerves, doubled into loops, which give little
prominences called papillae. Fig. 43 gives an ideal view of these
elevations, composed as they are, of a nerve, an
artery, and a vein, lying side by side ; 1, 1,
represent the true skin ; 2, 2, the papillary
layer; 3, 3, the arteries; 4, 4, the veins; and
5, 5, the nerves of the papillae.
The arteries, veins, and nerves are spread
over the true skin in great numbers, — so pro-
fusely, that it is impossible to push the point of
the finest needle into it, without piercing a
blood-vessel and a nerve.
Fig. 44 gives a view of the skin : a, a, the
cuticle ; b, b, the colored layer of the cuticle ;
c, (?, d, d, the true skin ; e, e, e, faUcells ; /, /, /,
sweat-tubes.
The lymphatics are very numerous in the skin, besides which there
are oil-glands and tubes, and sweat-glands and tubes.
Fig. 45.
The Oil-Glands are imbedded in the skin, and communicate with
the surface by small tubes. They are most abundant on the face,
ANATOMY.
49
nose and ears. Fig. 45 shows an oil-gland, — a, being the gland, 5.
the tube, and <?, its mouth.
^ 1 2
3 2 Fig. 46.
The Sweat=Apparatus consists of small tubes which pass down
through the true skin, and terminate in the meshes at the bottom,
where it coils upon itself into a kind of bundle, called the perspira-
tory gland. Fig. 46 gives one of these tubes, with the gland, mag-
nified forty diameters ; 1, being the coiled tube or gland ; 2, 2, the
two excretory ducts from the gland. These uniting form one spiral
tube, which opens at 4, which is the surface of the cuticle ; 3, are the
fahcells.
The hair and the nails are appendages of the skin.
The Nervous System.
The Nervous System consists of the brain and spinal cord., con-
nected with each other, and called the cerebrospinal axis ; the cranial
nerves ; the spinal nerves and the sympathetic nerve.
The Brain is that mass of nervous matter lodged within the skull-
bones. It is made up of three prin-
cipal parts, — the cerebrum., the cere-
bellum., and the medulla oblongata.
These are nicely covered and pro-
tected by three membranes, the dura
mater., the arachnoid, and the pia
mater.
Fig. 47 shows a considerable por-
tion of the brain, — the skull-bones
and membranes being removed.
The scalp turned down is repre-
sented by A, A ; E, E, E, show the cut
edge of the bones ; c, is the dura
mater, drawn up with a hook ; F,
the convolutions of the brain.
The Cerebrum is the upper and
larger portion of the brain, and is
Fig. 47.
50
ANATOMY.
divided into two hemispheres by a fissure. A portion of the dura
mater dips into this cleft, and from its resemblance to a sickle, is
called the falx cerebri. The design of this seems to be to support
each half of the brain, and to prevent it from pressing upon the other
half when the head reclines to one side.
The undulating surface of the cerebrum is produced by what are
called convolutions. The lower surface of this organ is divided into
three lobes, — the anterior, the middle, and the posterior.
The surface of the cerebrum is of a gray color, called cortical., or
cineritious ; the central portion is white and fibrous, and is called
medullary.
The Cerebellum is about one-sixth the size of the cerebrum. It
lies just under the posterior lobe of the cerebrum, and is separated
from it by an extension of the dura mater, called the tentorium. It
is composed of white and gray matter ; when the former is cut into,
there is presented the appearance of the trunk and branches of a tree.,
called arbor vitce.
The Medulla Oblongata is the top of the spinal cord; but being
within the enclosure of the skull, it passes for a portion of the brain.
It consists of three pairs of bodies, united so as to form a bulb.
The Dura Mater is a strong, fibrous membrane which lines the
skull and spinal column, and sends processes inward to support the
brain, and forward, as sheaths for the nerves which go out from the
brain and spinal cord.
The Arachnoid is a serous membrane, and like all other serous
membranes, is a closed sac. It is reflected upon the ihner surface of
the dura mater.
The Pia Mater is a vascular membrane, and lies next to and in-
vests the whole surface of the
brain, — dipping into its con-
volutions. It furnishes nu-
triment to the brain.
The Cranial Nerves which
go out from the brain are in
twelve pairs. In reading a
description of them, let the
reader keep his eye on Fig. 48.
The First Pair, olfactory
(6), passes through several
small openings in the ethmoid
bone, and is distributed to
the mucous membrane which
lines the nose. Destroy this,
and the sense of smell is gone.
Fig 48.
ANATOMY.
51
The Second Pair, optic nerve (7), passes through the base of the
skull, and enters the cavity of the eye where it is expanded upon the
retina. It is a disease of this nerve which occasions a gradual loss
of sight, called amaurosis.
The Third Pair, motores oculorum (9), passes through the sphe-
noid bone to the muscles of the eye.
The Fourth Pair, patheticus (10), passes to the superior oblique
muscle of the eye.
The Fifth Pair, trifacial nerve (11), like the spinal nerves, has two
roots, and divides into three branches, one going to the eye, forehead,
and nose, called the ophthalmic branch ; another going to the eye,
the teeth of the upper jaw, etc., called the superior maxillary ; and
the third going to the ear, the tongue, and the teeth of the lower
jaw, and called the inferior maxillary. It is a painful condition of
the branches of the fifth pair which constitutes the terrible neuralgic
affection called tic-douloureux.
The Sixth Pair, abducentes (12), passes the opening by which the
carotid artery enters the cavity of the skull, and goes to the external
straight muscle of the eye.
The Seventh Pair, portio mollis (13), is distributed upon the in-
ternal ear.
The Eighth Pair, facial nerve (14), is distributed over the face.
It sends nervous filaments to the muscles.
The Ninth Pair, glosso-pharyngeal nerve (14), passes through the
same opening with the jugular vein, and is distributed upon the mu-
cous membrane of the tongue and throat.
The Tenth Pair, pneumogastric nerve (15), sends its branches to
the pharynx, larynx, gullet, lungs, spleen, pancreas, liver, stomach,
and bowels.
The Eleventh Pair, spinal accessory nerve (16), connects with the
ninth and tenth pairs, and is distributed to the muscles of the neck.
The Twelfth Pair, h3q)o-glossal nerve (17), goes to the tongue,
and is its motion-producing nerve. It is a nerve of great energy in
those who talk much.
The Spinal Cord extends from the medulla oblongata, where it is
in connection with the brain, down to the second lumbar vertebra.
The upper end of the cord presents a bulbous swelling, or enlarge-
ment. Another swelling is found where the nerves are given off
which go to the upper extremities ; and a third near the end of the
cord, where the nerves begin which go to the lower extremities.
Fissures dip into the cord before and behind, and divide it into
two lateral parts, which are united by a thin layer of white substance.
These lateral columns are divided by furrows into anterior^ lateral.
52
ANATOMY.
and posterior columns ; — the anterior being supposed to be the motor
column, the posterior that of sensation^ and the lateral divided in
function between motion and sensation.
The 5pinal Nerves, connecting with the cord, are in pairs, of
which there are thirty-one. Each pair has two roots, — a motor root,
C, Fig. 49, arising
from the anterior
columns of the
cord, and a sensi-
tive root, D, spring-
ing from the pos-
terior columns. A,
is a section of the
cord, surrounded
by its sheath. B,
is the spinal nerve,
formed by the
union of the motor and sensitive roots. After the union, the nerve,
with its motor and its sensitive filaments, divides and subdivides
as it passes on, and is distributed to the tissues of the several
organs.
The thirty-one pairs of spinal nerves are divided into eight pairs of
cervical^ twelve pairs of dorsal^ five pairs of lumbar, and six pairs of
sacral nerves.
Fig. 50 gives a view of the brain and spinal cord, with the nerves
given off by the latter: 1, 1, being the two hemispheres of the brain;
3, 3, the cerebellum ; 4, the olfactory nerve ; 6, the optic ; 7, the
third pair ; 8, the pons varolii, so called ; 9, the fourth pair ; 10, the
lower portion of the medulla oblongata; 11, 11, the spinal cord; 12,
12, the spinal nerves ; 13, 13, the brachial plexus ; 14, 14, the lum-
bar and sacral plexus.
The Brachial Plexus is formed by the interlacing of the four lower
cervical and upper dorsal pairs of nerves. It gives off six nerves,
which are distributed to the muscles and skin of the upper extremi-
ties.
The Lumbar and 5acral Plexus is formed by the last dorsal and
five lumbar nerves, from which nerves go to the muscles and skin of
the lower extremities, and the last lumbar and four sacral, from
which nerves are sent to the muscles and skin of the hips and lower
extremities.
The Sympathetic Nerve consists of a series of knots (ganglia),
lying along on each side of the spinal column, and forming a knotted
chain. There is a knot for each intervertebral space, the neck ex-
cepted. These knots are composed of both cineritious and medullary
matter.
ANATOMY.
53
Each knot is a distinct centre, and gives off branches upward,
downward, externally, and internally. All the internal organs are
Fig. 60,
Fig. 61.
supplied with branches from the sympathetic nerve. It is called the
nerve of organic life, and is supposed to
preside over nutrition, secretion, etc., as the
nerves of the brain and cord preside over
motion and sensation.
Fig. 51 is a fine representation of the
great sympathetic, with its knots, and con-
nections with other nerves. A, A, A, is
the semilunar ganglion and solar plexus,
lying just under the diaphragm and behind the stomach. Its pres-
ence in this region is the reason why a blow upon the pit of the
stomach sometimes destroys life. D, D, D, are the thoracic ganglia ;
E, E, the external and internal branches of the same ; G, F, the
right and left coronary plexus upon the heart ; I, N, Q, the inferior,
middle, and superior cerArical ganglia; 1, the renal plexus around the
Fig. 62.
54
ANATOMY.
kidneys ; 2, the lumbar ganglion ; 3, the internal branches ; 4, the
external branches ; 5, the aortic plexus.
Fig. 52 represents a plexus, showing how the filaments of one
nerve pass to be enclosed in the sheath of another. In this way they
change at once the direction of their journey, and their companions
upon the way.
The Organs of Sight.
The organs of vision are the optic nerve, the globe of the eye, the
muscles of the eye, and the organs of protection.
The Optic Nerve begins by two roots at the base of the brain, the
fibres from which meet, as they come forward, and some of them cross
each other. The two nerves then sepa-
rate, and enter the back part of the
globe of the eyes, and then spread out
into a kind of membrane. In Fig. 53 :
1, 1, show the globe of the eye ; 2, the
crossing of the optic nerve ; 8, the
origin of two pairs of cranial nerves.
The Globe of the Eye is a better
constructed optical instrument than
man ever made. Its interior is filled
with what are called refracting humors
or mediums, which are surrounded and
held in their place by membranes, called coats.
The Coats are the sclerotic and cornea ; the choroid, iris, and ciliary
processes ; and the retina.
The Sclerotic Coat is a fibrous membrane, covering the largest
portion of the globe. To this the muscles are attached. It is the
part which is called the white of the eye. It has a beveled edge in
front, into which the cornea is fitted.
The Cornea is a transparent layer which projects in front, and forms
about one-fifth of the globe. It is shaped like a watch-glass. Its
blood-vessels are too small to receive the red particles of blood.
The Choroid Coat is a vascular membrane. Its color is brown ex-
ternally, and black within. It is connected with the sclerotic coat
externally, and internally with the retina. It is composed of three
layers.
The Iris is named from its having a variety of colors in different
persons. It is the partition between the anterior and posterior cham-
bers of the eye, and has a circular opening in the centre called the
pupil. Of its two layers, the fibres of the anterior one are radiating,
and dilate the pupil, while those of the other are circular, and cause
its contraction.
ANATOMY.
55
The Ciliary Processes are a number of folds formed from the in-
ternal layer of the choroid coat.
The Retina has three layers. The external is extremely thin ; the
middle is nervous, being an expansion of the optic nerve ; the in-
ternal is vascular, and consists of a ramification of minute blood
vessels.
The divided edge of their coats may be seen in Fig. 54, namely,
the sclerotic, the choroid, and the retina : 2, is the pupil ; 3, the
iris ; 4, the ciliary process ; 5, the scolloped border of the retina.
64.
The Humors of the Eye are the aqueous, the crystalline, and the
vitreous.
The Aqueous or watery humor is situated in the chambers of the
eye. It is an albuminous fluid, with an alkaline reaction, and a spe-
cific gravity a little greater than distilled water.
The Crystalline Humor is immediately behind the pupil. It is a
lens, and is convex both on the posterior and the anterior surface.
The Vitreous Humor is also an albuminous fluid something like the
aqueous humor, but more dense.
In Fig. 55 we have in E a good view of the cornea fitted into the
sclerotic coat ; A, is the choroid ; B, the pigmentum nigrum , C,
the retina ; K, the vitreous humor ; D, the optic nerve ; I, the lens c
C, the Iris, painted on the backside with pigment; F, the aqueous
humor.
The muscles of the eye, six in number, are attached to the bones
of the orbit behind, and to the cornea in front, by their tendons.
These tendons give the eye its pearly appearance. In Fig. 56,
five of the muscles are indicated by a, h, c, d, e; f, is the optic
nerve.
If the internal muscle be too short, the eye is drawn in towards
the nose, and the squinting called “ cross-eye ” is produced.
56
ANATOMY.
The Orbits are bony sockets which enclose the eye. The optic
nerve passes through a large hole at the bottom.
The Eyebrows are the projecting arches above, covered with short
hair. They prevent the sweat from running down into the eyes, and
also shade them from strong light.
The Eyelids are the curtains which rise and fall in front. The
smooth membrane which lines them is called the conjunctiva. It
secretes a fluid which makes the eyelids open and shut easily.
Fig. 56.
The Lachrymal Gland is at the upper and outer angle of the
orbit. Several small ducts open from it upon the upper eyelid,
through which the tears run down upon the conjunctiva.
The Lachrymal Canals begin near the [internal angle of the eye,
by two small-tear points, which communicate with the sac at the
upper part of the nasal duct.
The Nasal Duct is a canal about three-quarters of an inch long,
which runs down to the inferior channel of the nose.
Fig. 57 shows these organ : 1, being the lachrymal gland ; 2, the
ducts leading to the upper eyelid; 3, 3, the tear-points (puncta
lachrymalis) ; 4, the nasal sac ; 5, the termination of the nasal duct.
Fig. 67.
The Organs of Hearing.
The External Ear is composed of the pavilion of the ear (the pinna),
and the auditory canal (the meatus auditorius externus).
The Pinna surrounds the entrance to the auditory canal. It stands
out from the head, and is in common language called the ear.
The rieatus Auditorius in a canal about an inch long, partly bony
and partly cartilaginous, which goes from the pavilion of the ear to
the drum of the ear.
The Drum of the Ear (membrana tympani) is an oval-shaped thin
membrane, inserted into a groove around the auditory canal.
ANATOMY.
57
The Tympanum is a cavity within the temporal bone.
The Eustachian Tube is a
channel of communication be-
tween the tympanum and the
upper part of the pharynx.
The object of this is to convey
air to the di’um of the ear, as
without air no sound can be
produced.
The Labyrinth is a series of
chambers through the petrous
bone — embracing the vestibule,
a three-cornered cavity within
the tympanum ; the semi-circu-
lar canals, communicating with
the vestibule, and the cochlea,
which makes two and a half turns around an axis, called the
modiolus.
In Fig. 58, a, is the pa*
vilion of the ear ; c, the
auditory canal ; g, the mem-
brana tympani ; k, the tym-
panum ; e, the bones of the
ear; h, the semicircular ca
nals ; f, the cochlea; A, the
vestibule ; i, the eustachian
tube ; d, the auditory nerve.
In Fig. 69, we have a
view of the labyrinth laid
open, and highly magnified :
1, 1, being the cochlea ; 2,
3, the channels that wind
around the central point
(5) ; 7, 7, the vestibule ; 8,
the foramen rotundum; 9,
the fenestra ovalis ; 4, 6, 10, the semicircular canals.
HYGIENE
Physiological Laws of Life and Health
It is absolutely necessary that every person should be conversant
with Hygiene^ to understand the laws of health.
PHY8I0L0GICAI LAWS OF LIFE AND
HEALTH.— HYGIENE.
Life, the Infancy of Being.
It may be stated as a general truth that man has but just learned
to live when he is ready to die. We expend a large portion of our
lives in searching out our mistakes, and in striving to undo the mis-
chiefs they have occasioned. This is true in reference both to our
moral and our physical life ; and I draw from it the conclusion that
the present must be only the infancy of our being, and that our blun-
ders and consequent sufferings here will cause us, in the great here-
after, to place a higher value upon knowledge, and to struggle with
new fortitude to rid ourselves of every bondage.
A life which has just begun to take shape and symmetry, cannot
be permitted, I think, under the rule of a benevolent Creator, to be-
come extinct. We shall certainly be permitted to take up the broken
thread of life, and, in the clearer light of the future, with the warning
experience of the past, and surrounded by better guards, to try again.
In the meantime, while here, the sooner we become acquainted with
the laws of life, and the better we obey them, the more we shall en-
joy-
The Nervous System.
Man is brought into connection with the outward world through
the senses of feeling, seeing, hearing, etc. These communicate with
the brain and mind through the nerves of sensation.
The nervous system is divided into two great central portions,
the brain and the spinal cord ; and these together are called, by the
learned, the cerebrospinal centre. There are numerous pulpy white
cords, called nerves, which at one end are connected with this great
axis or centre, and from thence run to all parts of the system. A
portion of these nerves start from the base of the brain and run to
the eye, the ear, the tongue, etc. (Fig. 48) ; while another, and a
larger part spring from the cord which runs through the backbone,
and are distributed over the body and the lower extremities (Figs.
50 and 60). One portion of these cords produce feeling ; another
part, motion. The former we call sensitive ; the latter, motor. Both
^nds are widely distributed over the body. Those which spring
from the spinal cord have two roots, one uniting with the back, the
60
HYGIENE.
other with the front part of the cord. Cut off the hack root, and the
part to which it is distributed loses its feeling. As we say in com-
mon language, it be-
comes numh, though it
may move as well as
before. Cut the front
root, which is motion-
producing, and the part
to which it goes cannot
move. It is palsied^
though it may still feel
acutely. The numerous
nerves that spring from
the spinal column are
pretty well represented
in Fig. 60.
If the cranial nerves
of motion which go to
the face be cut, no emo-
tion or passion can be
expressed. The features
will all be immovable,
like statuary. To smile,
to laugh, to frown, to
give expression to the
feeling of pity, or an-
guish, or love, is alike
impossible. And yet a
breath of air upon the
face will \>q felt as readi-
ly as before. Paralysis,
or palsy, as it is called,
partial or general, is the
resultof injuryuponfew
or many of these motion-
producing nerves. Neu-
ralgia, tic douloureux,
etc., arise from some
disease, perhaps inflam-
mation, of the nerves of
sensation.
Fig. 60,
How the Mind gets Knowledge. Everything the mind knows
of the external world, it learns through the the organs of sense, which
communicate with it through these nerves. Thus, the nerves are
acted on by external agents, and then they act on the brain and cause
sensations. When the hand is burned , the nerves of sensation run
with the intelligence to the brain, which, quick as thought, through
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HYGIENE.
61
the nerves of motion, despatches orders to the muscles to repel the
injury.
Comparison. — The arrangement and operation of the nervous
system are like those of the electric fire-alarm system of a city.
The brain is the intelligent centre, like the central office. The
nerves of sensation which carry to the brain, with electric speed,
intelligence of what is going on outside, are like the wires which run
to the central station from the several boxes. The quick carry-
ing to the brain of any information of injury done to some part of
the body, is like sending to the central station from an alarm-box
the intelligence of fire in one of the districts. The rapid transmis-
sion of orders from the mind to the muscles is like flashing the alarm
over the wires to every part of the .-ity. And, finally, the powerful
action of the muscles in warding oh’ danger is like the dashing of
firemen over the pavements and the energetic playing of the
engines.
Sensations.
An effect produced on the mind through a nerve is called a
sensation. Hunger is a sensation. It is an effect produced upon the
mind through a certain nerve by the condition of the stomach.
Thirst, pain, heat, cold, are sensations in a similar sense. Nausea
is a sensation produced by some injurious substance acting upon the
coats of the stomach.
Strength of Sensation. — Some sensations are much stronger
than others; some are very intense. A very strong sensation is
called a feeling. It is common to say, “I feel cold,” or, “I feel hot.”
We simply mean by this, that the temperature of the weather makes
a very powerful impression upon us.
Kinds of Sensation. — Sensations are either pleasurable or pain-
ful. Pleasurable sensations arise from the proper exercise of some
healthy part of the body ; and they are a suitable reward for any
care the mind may take of the corporeal organs.
The sensations arising from a proper amount of exercise are
pleasurable. The muscles find a sort of enjoyment in action. He
who leads a sedentary life, either from choice or necessity, loses much
enjoyment. Hence, there is pleasure in labor ; and the working-man,
though often pitied by the wealthy, is generally the happiest of men.
The eye and the ear, when directed to agreeable sights and sounds,
derive the most agreeable sensations from exercise. The air of a
beautiful spring-morning gives impressions which none can describe,
but which all know to be delightful. These impressions are well
fitted to reward us for taking at that season, in the open air, the ex-
ercise we so much need.
Moral Uses of Sensations. — How little we reflect upon the
amount of happiness it is in our power to create by making agreeable
62
HYGIENE.
impressions upon others. A civil and polite address makes a pleasant
impression. A kind word, fitly spoken, makes the heart glad. Heads
of families might do much to increase the happiness of their domes-
tics in the kitchen by meeting them with a pleasant countenance, and
dropping in their ear, now and then, a word of approval. Such little
acts of benevolence are easily performed, and they make the most
agreeable and lasting impressions upon persons in the lower stations
of life, — creating attachments, in fact, which end only with death,
and which in hours of future sorrow, which come to all, may refresh
us like springs of water in the desert.
“ Full many a shaft at random sent,
Finds marks the archer little meant;
Full many a word at random spoken.
May heal a wounded heart that’s broken.”
Sib Walter Scott.
In aiming to make agreeable impressions upon domestics, we should
be governed by the simple desire to create happiness. Their sources
of happiness are comparatively fevv^. They spend their days below
stairs, — shut out from a portion of the light of day, and from the
refining influences of the drawing-room, — having little time for rest
or for recreation. How unfeeling to treat such persons with harshness,
to wear a frowning face in their presence, and thus wither the few
flowers of happiness which bloom around them !
Every human being is endowed with the beautifu’ nervofls organ-
ism of which I have spoken, and is daily receiving impressions, pleas-
urable or painful, from thousands of sources. In all the relations of
life, it should be our aim to touch delicately this sensitive structure.
Wives may add much to the happiness, and I may say, to the affec-
tion of their husbands, by always wearing a pleasant face ; and the
heart of the wife may be made light and glad by gentle words from
the husband. We cannot but love those who make pleasurable im-
pressions upon us, and we necessarily dislike such as impress us pain-
fully. Most of the coldness and alienations which grow up between
the heads of families, spring from the habit of one of the parties, of
saying, or doing, or looking something which painfully impresses the
other. A woman who habitually wears a “sour ” face cannot be
loved either by her husband or her children. The man or the woman
who desires to be loved, must cultivate a manner, a look, a speech, a
life, the whole scope of which is fitted to make pleasurable impres-
sions upon others. It is against nature to love what gives us pain.
Agreeable Sensations a Source of Health. — Pleasurable sensa-
tions not only beget love, and increase happiness, but they add much
to health. They exhilarate the spirits and drive away melancholy.
TravelKng promotes health and prolongs life, by the number and
variety of the pleasing impressions it makes upon the mind.
Care of the Sick. — If the above statements be con-ect, how im-
portant that the sick should be so dealt with as to have none but
HYGIEKE.
68
agreeable sensations made upon them. Many a life has been sacri-
ficed to the peevish temper of a nurse. When the nerves are weak
from disease, even slight causes make powerful impressions ; and if
these impressions are of a painful kind, the results are most deplora-
ble. To treat harshly the sick, especially those whose nervous system
is broken, implies either great thoughtlessness or extreme cruelty. A
single harsh word, which would scarcely move one when well, may
send the same person, when sick, almost to distraction. Every word
spoken to persons in sickness should, therefore, be gentle and sooth-
ing. Every feature of the face should express either cheerfulness,
or tenderness and pity.
As the painful impressions which disease is making tends to de-
press the spirits and create melancholy, it is not expected that persons
when sick will exhibit as amiable tempers as when well ; and for
this all due allowance must be made.
Effect upon the Disposition. — This leads me to say that pleasur-
able sensations improve the temper and disposition. This is a fact of
very great importance, and parents should never lose sight of it in
dealing with their children. There are few children but would grow
up amiable and useful members of society, were they dealt with in
the gentle and tender manner which their young and impressible
natures require. From the moment the young mind wakes to intelli-
gence, it will be occupied with something. Parents and guardians
should aim, therefore, to turn it to all those things which will impress
it pleasantly, and at the same time do it no harm. Exercise, songs,
playthings, flowers, — to these and other entertainments it should be
led by gentle hands. No thoughtful parent will ever pain a child
by harsh threats and denunciations, or shock it by an oath.
Bad Effect of Unpleasant Sensations; — If pleasurable sensations
improve the health and temper, unpleasant ones do just the opposite.
They break down the health and spoil the disposition.
They are intended to give us a warning of impending injury.
Thus, we have painful sensations when we have overworked the body
or mind. The sensation of weariness tells us that the muscles have
worked as long as their good requires, and that they need rest. Were
this sensation unheeded, exhaustion and entire prostration would be
the result.
When fatigue begins to be felt, either of body or mind, the sensa-
tion may be dissipated by strong tea, or intoxicating drink, or opium ;
but to drive it away in this manner, for the purpose of working longer,
is wrong, and leads, in the end, to disease or exhaustion. It was said
that one of the most brilliant advocates of recent times was dependent
upon opium for the stimulus to carry him through his extraordinary
flights of eloquence; but his restless motion and nervous face reminded
one that he had bent his bow very nearly to the snapping point, and
that a sudden collapse of his vital powers, at no distant day, might
be feared as the result of such tension.
64
HYGIENE.
Persons in affliction, whose spirits are aepressed and broken by
sorrow, should have their thoughts turned away from all sombre ob-
jects and contemplations. They should be taken into the open sun-
light, and be diverted by the beautiful things of nature. They
should visit cheerful society, and open their hearts to pleasurable im-
pressions.
When we permit any part of the body to remain idle, neglecting
to use it as much as we ought, unpleasant sensations remind us of
our fault. The muscles, when unused, waste away and become
feeble. This is sure to produce an uneasy, nervous state of feeling,
which says to us as plainly as a sensation can, that the muscles are
hungry for exercise, and that it is injurious to let them rest longer.
Need of a Healthy Brain. — In order that we may get correct
ideas of the external world, it is necessary that the brain, the nerves, and
the organs of sense through which sensations are made upon the
mind, should be in a healthy condition. It is evident that if the in-
struments of sensation be diseased, the sensation cannot be natural,
and will make a false report to the mind. It is of the highest im-
portance, therefore, that the brain should be sound.
Improper Intermarriages. — This organ, like every other, may
inherit disease from parents. Insanity, which springs from a dis-
eased brain, is often hereditary. When both parents are diseased,
the offspring are of course more liable to partake of their defects.
Among the wealthy, and particularly among the royal families in
Europe, nervous diseases and sterility are very common. This
arises, in a great part, from intermarriages among blood relations, — a
practice under wliich any people will degenerate, and finally perish.
The wisdom of the Old Testament prohibition of marriage within
certain degrees of consanguinity has been established by the obser-
vation of pliilosophers and the experience of mankind. Let those
who will transmit to their descendants a sound mind in a sound
body, observe the laws of life, and avoid all marriages with blood
relations.
Need of a Good Supply of Blood. — For a proper performance
of its duties, the brain requires and receives a larger supply of blood
than any other part of the system. One-tenth of all the blood goes
to this important organ. If the quantity or quality be materially
lessened or changed, great disturbance of the brain follows. A large
loss of blood occasions dizziness and fainting. If an atmosphere
charged with too much carbonic acid gas be breathed, as in a deep
well, the blood is not vitalized in the lungs, so as to sustain the
brain, and unconsciousness soon follows. If the air be vitiated in
any way, or have its oxygen extracted, as in large assemblies, where
it is breathed over several times, it becomes unfit to support the
brain, and the result is languid feelings, inability to apply the mind,
headache, fainting, hysterics, and other nervous manifestations.
HYGIENE.
65
Ventilation. — This shows the great necessity of having dwellings,
churches, and school-houses well ventilated.
Were a good system of ventilation adopted in all our churches,
ministers would seldom preach to sleeping audiences. A congrega-
hon sitting in one of our places of public worship, where the air in
,1 single afternoon is as many times used over as the minister’s ser-
jaons are in a lifetime, can neither hear with attention, nor compre-
hend with clearness.
In many of our school-houses, the ventilation is quite as bad, and
the consequences worse, because they are occupied six hours of the
day instead of three, and five days of the week in place of one. In
the small school-houses which our children filled to overflowing in
former years, in which there was no ventilation, unless they happened
to be blessed with an old-fashioned chimney and fire-place, the effects
upon the nervous system of the children was deplorable. Many of
the diseases which afflict the present generation of men and women
had their origin in the bad air of those crowded nurseries of edu-
cation.
Our dwellings were partly ventilated in olden time, when the
open fire-place received the “ back -log,” the “ top-stick,” the “ fore-
stick,” and other sticks to match ; but since we have been warmed
by the stove and the furnace we have known little of the luxury of
pure air at the domestic hearth.
Need of Exercise for the Brain. — Health requires that the
brain should be properly occupied with vigorous thought. The
same reasons may be given for this as for the exercise of the muscles.
It is governed by the same laws which apply to other parts of the
system. Use improves its strength and vigor ; idleness causes it to
grow feeble. Of course the labor it is put to should be only reason-
able in amount, and should not be too long continued at any one
time. With the weakening of the brain, the whole bodily forces,
and indeed the whole mental and moral character, fall into feebleness
and decay. It is a great mistake to suppose that the cultivation and
even vigorous use of the mind impairs health and shortens life.
Just the opposite is true. Many of the most eminently intellectual
men, who have worked their brains hard all their lives, have been
distinguished for long life.
Bad Effect of Change in Circumstances. — No class of persons
suffer more from nervous diseases and general ill-health than those
who, having worked hard in early life, with little or no cultivation
of the mind, are suddenly raised to wealth, and immediately drop all
exercise, and fall into habits of indolence and luxury. The condition
of such persons would be much less pitiable, did they take up books
when they lay by the hoe or the broom. But they seldom do this. Many
a woman, in early life, has felt the glow of health in every limb,
and a thrill of pleasure, too, while scrubbing the floor on her hands
66
HYGIENE.
and knees, who has, in subsequent years, reclined in misery upon
her damask-covered lounge, and wondered that she could not have
the health of other days. Let her cultivate her brain, live temper-
ately, and exercise in the open air, and life may again have real
pleasures for her.
Discretion in Exercising the Brain In exercising the brain
we must use discretion. We must not sit down in the morning, and
ply it with work during the whole day, without rest. This would
soon bring upon it disease, or premature decay. It should be worked
only until it begins to show symptoms of fatigue. Then it should be
permitted to rest ; or, what is better, be turned to some new subject, of
a lighter, or a different character. This often rests the brain better
than to entirely suspend its action.
Overworking the Brain in Childhood. — Great care should be
used not to exercise the brain too much in early life. Like other
parts of the system, it is tender in childhood, and will not bear pro-
longed exertion. As a general thing, children are put to school too
early, and made to work their brains too hard. Great mischief arises
from this source. Children are born with larger brains now than
formerly ; and it is no uncommon thing to see upon a child of ten
years, a head equal in size to that of an adult. Children run to
Drain. Precocity in development of brain and mind is common.
The results of stimulating and hastening the unfolding of such minds
are deplorable. In such children, the brain should be the last thing
to be cultivated. We do not need to urge its growth. It will come
forward fast enough in spite of us. Our chief aim should be to harden
and fortify the general constitution, so that the brain which it is
required to bear up and sustain may long be its crown and glory.
Yet parents are proud of their precocious children, and often re-
verse this rule. They do it thoughtlessly, and would be terribly
startled could they suddenly look into the future and see the results
of their folly. Could they do so, they would see inflammation and
softening of the brain, epilepsy, insanity, paralysis, apoplexy, with all
the horrors of undescribed and indescribable nervous affections, which,
though without a name, have a terrible reality.
Old People’s Brains. — Persons in advanced life should be par-
ticularly careful not to overwork the brain. In middle life it re-
covers easily from great fatigue. In the decline of life, its powers
of recovery are feeble. A single exhaustion may cause its fatal col-
lapse. Old age should be distinguished for gentleness and modera-
tion. The journey of the down-hill of life should be made by short
and easy stages, through regions of diversified beauty.
A Supply of Blood. — Every part of the system, when hard at
work, needs and must have a very large supply of pure blood.
Without this, it is torpid and inactive. To cause the blood to flow
to any particular part, it must be exercised. The lumberman, when
Physicians Publishing Co., Boston, Mass.
SCIATIC
POPLITEAL
BASE OF BRAIN
BRACH lAL
PLEXUS
ULNAR
RADIAL
BRAIN
CERVICAL 7 NERVES
POST TiBIAL
DORSAL 12 NERVES
LUMBAR 5 NERVES
SACRAL LOWER
5 NERVES
NERVES OF THE HUMAN BODY
HYGIENE.
67
in the forest in extreme cold weather, stamps his feet violently upon
the ground, or beats them against a log, and whips his hands around
his body, and in this way makes them red and warm with a new
supply of blood. The stomach, when it has received a supply of
food, begins earnestly to turn it over ; and by this exercise, and the
stimulus which the food supplies, it invites large quantities of blood
to its vessels, and thus increases its power to work. But just in
proportion that it draws the vital current to itself ^ and augments its
own vital force, it diminishes the blood in other organs, and for the
time being, unfits them for work. The same may be said of the
brain and all other working organs.
From this it follows that only one organ, or set of organs, can
work effectively at the same time, and that it is improper to put the
brain to hard work immediately after a full meal, because the
stomach then wants the blood to enable it to digest the food ; and if
the blood be called off to the brain, digestion will stop. Nor should
the stomach be loaded with food directly after long and hard
thinking ; for the brain will yield up the blood to it only after its
own excitement has had time to subside.
Sympathetic Nervous System.
Tbte object of this system seems to be to bind all parts of the
body together, and to combine and harmonize their actions. It takes
care that no part of the system acts in such a way as to injure any
other part. It exerts a controlling influence over digestion, nutrition,
absorption, the circulation, etc. These are natural processes which
need to go on while the brain is asleep and cannot attend to them.
The nervous system, of which I speak, presides over all those func-
tions which are called involuntary, — so called because no act of the
will is needed for their performance. Secretion, absorption, digestion,
and the circulation of the blood, all have to go on while we sleep, as
well as while we wake. Were an act of the will necessary to their
performance, as in walking, eating, conversing, etc., then they would
have to cease the moment the brain fell asleep, and death would be
the result.
The sympathetic nerves apprise each part of the system of the
condition and wants of every other part. When the lungs are in-
flamed, the stomach seems to be aware of it, and will receive no food,
because this would aggravate the disease of the neighboring organs.
Well would it be if human beings would exercise a like forbearance,
and abstain from those acts of self-gratification which they know will
injure their neighbors.
Effects of Nervous Diseases. — Before closing these observations,
I wish to add a few words respecting the terrible effects of nervous
diseases which characterize the present time.
That they are far more numerous and afiSictive than in former
68
HYGIENE.
years, must be apparent to the most careless observer. They are
nothing more nor less than the price we pay for a high civilization,
and especially for our democracy. Among us, every man feels his
individuality, and has a motive for thinking and doing his best.
Thought and action are here unfettered ; and if the race is not to
the swift, nor the battle to the strong, every man acts as though he
thought it was. The great excitement which the struggle for wealth
kindles and inflames, deranges and shatters the nervous system to a
shocking degree.
And wealth, when obtained, does its full share to weaken the
nerves. It brings with it high living, indolence, loss of energy, dis-
sipation, and a weakening of the whole moral and physical powers.
It need not do this ; but, in most cases, it does.
The result is, that, at least, every other person has some nervous
disease, which makes life a misery rather than a blessing. The brain
and nerves are too much developed in comparison with the develop-
ment of the muscles. Half our boys and girls have heads as large
as men and women. It is common to see a boy or a girl at ten talk-
ing and acting like a man or woman. I do not mean by this, that
they imperfectly imitate the actions of older persons. It seems to be
natural to them. Their brains are prematurely developed, and their
acts and thoughts have the maturity of adult life.
What is Coming? — What will be the result of this state of
things, no man can predict. I sometimes think the race will break
down ; that that which was intended to be its ornament and strength
will be its destruction. I hope not. Yet there is danger of it.
Nothing can save us but the wisdom to adopt such means as will
develop all parts of the system alike. No race of men can stand for
many generations such a strain upon the nervous system, unless bet-
ter means are adopted to counterbalance its evil effects than are now
used in the United States. We have got to pause in our swift
career, and look after our health, or we shall become a nation of
maniacs. No proof is needed of what is here said.
Hopeful Considerations. — It is proper to say, the considerations
here presented, terrible as they are, are mitigated in some measure by'"
others of a more hopeful character.
Physiology and the laws of life are now better understood than at
any former period. These subjects are getting into our common
schools, and are engaging the attention of our youth. Declining
health has already made us think more of the means of preserving
it, — such as diet, exercise, bathing, travelling, and amusement. To
encourage and intensify this hopeful direction of the public mind, I
propose to devote a few pages to these subjects.
HYGIENE.
G9
Food and Digestion.
Fbom the earliest dawn of existence to the last moment of life, our
bodies are constantly changing. Old particles of matter, when they
are worn out, leave their places and are thrown out of the system.
Were this the whole of the matter, our bodies would soon waste
away, and that would be the end of us. But as fast as the old mate-
rials are thrown away, new ones take their places ; and it is solely
out of our food that these new materials are formed.
In order that the food may be well digested, it must first be broken
into small particles in the mouth. The act of chewing it is called
mastication. During this act, if it be well performed, a large quan-
tity of spittle, called saliva, flows out of a number of glands, called
salivary glands, and mixes with the food, forming with it a soft mass.
In this condition, it is thrown backward into the top of the throat,
called the pharynx. Here, a little cartilage, called the epiglottis,
drops down upon the opening into the top of the windpipe, and pre-
vents its entrance into the breath-passage ; and it is pushed along
into the gullet, a tube which runs down behind the windpipe and
lungs, and which physicians call the oesophagus. Here a succession
of muscular bands, circular in shape, contract upon it, one after
another, and force it down into the stomach.
It is important that two things should be secured while the food is
in the mouth, namely, that it should be reduced to a good degree of
fineness by chewing, and that a proper amount of saliva should be
mixed with it. If the chewing were not necessary, teeth would not
have been given us ; and the salivary glands would certainly not have
been put in the mouth, if the mixing of water with our food would
serve the purposes of digestion as well.
Eating too Rapidly. — Americans have fallen into a pernicious
error in eating their food too rapidly. Time is not given to chew it
sufficiently to excite a full flow of saliva ; and as it cannot be swal-
lowed in a dry state, it is not uncommon to see persons taking a sip
of water after every second mouthful, to enable them to force it into
the stomach. It is a habit we Americans have of cheating ourselves
both of the pleasures and the benefits of eating ; for the only real
pleasure of eating arises from the flavor of food while retained in the
mouth, and the only benefit we can derive comes in consequence of
its proper digestion.
The food when received into the stomach is in the same condition
as when taken into the mouth, except that it is, or should be, ground
fine by the teeth, and well mixed with saliva.
The Gastric Juice. — The stomach, like the mouth, the windpipe,
and the gullet, is lined by a mucous membrane. The chief office of
this membrane is to secrete, or take out of the blood, a fluid which
we call gastric juice, which means stomach juice, from the Greek
70
HYGIENE.
name of stomach, yaa-rep (gaster). This fluid has not much smell
or taste, and looks like spring water. It has a powerful effect upon
food, which, when mixed with it, soon undergoes an important
change, which is apparent to the taste, the smell, and the sight. The
nature of the gastric juice and how it produces its effect upon food
are not certainly known ; but it contains two active elements, — a
free acid and pepsin, whose function is to dissolve the nitrogenous
parts of the food and convert them into albuminose or peptone. The
albuminose is absorbed by the coats of the stomach and enters
directly into the circulation ; while the sugar and fat pass on to the
duodenum to be acted upon by the bile, the pancreatic juice, and
other secretions of the bowels.
Too Much Cold Water at Meals. — There are some interesting
facts connected with the formation of this fluid, of which it is im-
portant that every person should be apprised.
Its quantity and quality depend on the amount and healthfulness
of the blood which flows to the stomach during the first stage of
digestion. It is, therefore, injurious to drink large quantities of very
cold water with, or immediately after, our meals ; as this will chill
the stomach, and repel the blood from its vessels, so that but little
of the juice can be formed. Digestion, in such case, must be im-
perfect.
This Fluid not Secreted Without Limit. — This fluid does not
flow into the stomach continuously, but only when we swallow food,
and then not as long as we please to eat, but merely till we have taken
what the system requires. If, in the amount we take, we go beyond
the wants of nature, there will not be fluid enough formed to dissolve
it, and the whole will be imperfectly digested, and be a source of in-
jury rather than benefit. This should teach us to be careful that our
food be only reasonable in amount.
Not Secreted in Sickness. — When we are sick, the gastric juice
is either not formed at all, or only in small quantities. Whatever
may be our feelings of lassitude, and however much we may appear
to need food, at such times, it is useless to take it, for it cannot be
digested, and will only aggravate our disease. If the illness be only
slight, the fluid will be formed to some extent, and food may be
taken in proportion.
Its Secretion Favored by Cheerfulness. — A cheerful disposition,
and a happy, lively frame of mind, are highly favorable to the pro-
duction of the gastric juice ; while melancholy and anger and grief
and intense thought of business, at the hour of meals, greatly hinder
its natural flow.
This should teach us to go to our meals with light hearts, and to
make the family board a place of cheerful conversation, and of a light
and joyous play upon the mirthful feelings of all present. Should
any of the family circle be in the habit of using vinegar as a condi-
HYGIENE.
71
merit, we should never be guilty of compelling them to extract it
from our faces. A vinegar face is not easily excused anywhere ; at
the table it is unpardonable. A single countenance of this description
will throw a gloom over a tableful of naturally cheerful persons ; and
if habitually present at the board, may finally spoil the digestion of
half a dozen, and entail dyspepsia upon them for life.
The stomachs of the sick pour out but very little of this fluid, and
they can take but a small amount of food. It is cruel to deprive
them of the power of digesting that little by treating them harshly,
and filling them with gloomy and desponding feelings. I therefore
repeat the substance of the advice given on a previous page : Deal
gently with the sick.
How all this is Known. — As the stomach is wholly concealed
from view, the reader will very naturally ask how it is known that
the gastric juice is poured into it in certain states of the mind, etc., and
withheld in others. It certainly could not have been so accurately
known, had it not been for an accident which opened the living and
working stomach to the inspection of Dr. Beaumont, a United States
Surgeon.' A young man by the name of Alexis St. Martin, a Cana-
dian by birth, but then in the State of Michigan, had a large part of
his side torn away, and a hole of considerable size made into his
stomach, by the accidental discharge of a gun. To the surprise of
his surgeon, St. Martin recovered ; and the edges of the wound in the
stomach refused to grow together, preferring rather to fasten them-
selves to the borders of the breach in the side, thus leaving the pas-
sage open. A kind of curtain grew down over this, which prevented
the food from falling out. Dr. Beaumont, taking advantage of this
state of things, instituted a series of valuable experiments, by lifting
the curtain, and inserting various articles of food, and witnessing the
process of digestion.
Movement of the Stomach. — The presence of food in the stom-
ach causes its muscular coat to contract and throw it about from side
to side, mixing it thoroughly with the gastric juice, and reducing it
to a pulpy mass, called chyme. This, as fast as it is properly pre-
pared, passes through the pylorus into the upper bowel, or duodenum,
called also the second stomach.
Chyme. — A certain witty professor of anatomy and physiology
was in the habit of asking his class if they ever saw any chyme ; and
when they answered, no, as they often did, he called their attention
to what is occasionally to be seen in the morning, upon the sidewalks,
where drunken men have held themselves up by lamp-posts, and left
the contents of their stomachs.
The pylorus, or opening into the bowel, has a very singular and
wise instinct, which is worthy of remark. When a piece of food,
which has not been digested, attempts to pass into the bowel, the
moment it touches the inner surface of this orifice, it is instantly
72
HYGIENE.
thrown back by an energetic contraction ; though a portion of well-
prepared chyme, touching the same opening immediately after, is
allowed to pass unchallenged.
Chyle. — The chyme, when it reaches the duodenum, seems to
cause the liver to secrete bile, and
the pancreas to produce pancreatic
juice. These two fluids are con-
veyed into the upper portion of the
second stomach, and there are mixed
with the chyme, and cause it to
separate into a delicate, white fluid,
called chyle^ and a residuum, which,
being worthless, is pushed onward,
and thrown out of the body.
Bile in the Stomach. — Most
persons suppose that the bile is gen-
. erally found in the stomach ; but
this is a mistake. It is thrown up
by vomiting, because in that act, the
action both of the first and the second stomach is reversed, and tin,
bile is forced up from the duodenum
— taking a direction the opposite ot
its usual course.
Destination of the Chyle. — Tht
chyle being separated from the dregs,
is pushed onward in its course by the
worm-like motion of the intestine ;
and as it passes along, it is graduall7
sucked up by thousands of very small
vessels, whose mouths open upon the
inner surface of the bowel. These
little vessels are called lacteals, from
the Latin word lac, which means milk,
because they drink this white, milky
fluid. Fig. 61 shows a section of the
small bowel, turned inside out, and
covered with the villi, or rootdike fila-
ments, closely set upon its surface, for
absorbing the chyle, and at the bottom
of which the lacteals take their rise.
In these lacteals, and in the mesen-
teric glands, the chyle is gradually
changed, so as to approach nearer and
nearer to the nature of the blood ; but
precisely what the change is, or how
it is effected, is not known. Several
Fig. 61.
HYGIENE.
73
learned men have published their theories upon these points, and the
writer has opinions upon them ; but it is not worth while to trouble
the reader with them. It is sufficient to say that the fluid is carried,
by the lacteals to the thoracic duct, through which it is conveyed into
a large vein at the lower part of the neck, where it is poured into
the blood, and becomes, after going through the lungs and experi-
encing another and a vital change, the material out of which our
bodies are daily and hourly new-created.
Fig. 62 gives a general idea of the stomach, bowels, etc. : 9, being
the stomach ; 10, 10, the liver ; 1, the gall-bladder ; 2, the duct which
conveys the bile to 4, which is the duodenum ; 3, is the pancreas ; 5,
the oesophagus ; A, the duodenum ; B, the bowels ; C, the junction of
the small intestines with the colon ; D, the appendix vermiformis ;
E, the ccecum ; F, the ascending colon ; G, the transverse colon ; H,
the descending colon ; I, the sigmoid flexure ; J, the rectum.
Nature and Destination of Food.
The food which man requires for his support and development is
of two kinds, inorganic and organic. The first of these embraces
certain mineral substances, as common salt, sulphur, phosphorus,
iron and lime, either in combination or separate.
These are not generally reckoned as aliments, and yet no human
being can live without them. In their absence, the body decays, dis-
integrates, and perishes. Common salt is composed of muriatic acid
and soda. The first is an important ingredient in the gastric juice,
and the latter promotes the secretion of bile. Sulphur is found in
several of the tissues, particularly in the muscles. Phosphorus,
united to fatty matter, is highly honored in forming a portion of
the brain and nerves, and is also combined with oxygen and lime to
make the earthy or hard part of bones.
Found in Food.- — These articles it is not necessary often to intro-
duce into the system in a separate state. They are contained, in
larger or smaller proportions, in most articles of food ; and man al-
ways suffers, as all animals do, from their absence. Common salt is
found in the flesh of animals, in milk, and in eggs. It is not very
abundant in plants ; and we all know how eagerly domestic animals
devour it when it is given to them, and how constantly wild cattle
resort to the salt springs, which, in the great W est, are called “ buffalo
licks.” Lime exists in nearly all animal and vegetable substances.
In wheat flour we get it in combination with phosphoric acid, that
is, as phosphate of lime. Lime exists too, in the state of carbonate
and sulphate, in all hard water. Iron is found in the yolk of eggs,
in .milk, in animal flesh, in potatoes, pears, cabbages, mustard and
other articles. Sulphur we get in flesh, eggs and milk ; and, as
sulphate of lime, in spring and river water. Phosphorus is derived
from eggs and milk ; and flesh, bread, fruits, and husks of grain,
V4
HYGIENE.
commonly called bran, contain even a larger proportion than we need
in our diet.
Organic Food. — The organic elements of man’s food, which in
bulk embrace almost the whole of it, remain to be considered. In the
animal economy they serve two great purposes. A part of the arti-
cles which compose them are blood-formers, out of which all the
tissues are made, — the other part produces fat, which serves to warm
the body by being burned with oxygen. These articles are derived
partly from the vegetable and partly from the animal kingdom.
Divided into Four Groups. — For convenience, these articles may
be divided into four groups. For the
first, sugar stands as a type. We there-
fore call it the saccharine group. It em-
braces starch, gum, and the fibre of wood.
These articles may all be converted into
sugar by a simple chemical process.
Figure 63 gives a microscopic view of
the granules of starch.
The second group we call the oleaginous.
It is composed of oily substances, from
whatever source derived, whether the an-
imal or the vegetable world.
The third group is the albuminous. A
good type of it is the white of egg.
T\\q fourth is the gelatinous., ox jelly group.
First and Second Groups, Supporters of Respiration. — The ar-
ticles composing the first and second groups are analogous in com-
position, all containing oxygen, hydrogen, and carbon. They are what
Liebig calls supporters of respiration ; the meaning of which is, in
more comprehensible terms, that they are supporters of combustion.
They are the fuel which warms us. They keep the fires going, from
which arises all the heat we have in our bodies. But they are desti-
tute of nitrogen, and, on this account, they are not blood-formers, and
cannot be worked into flesh. Hence, man cannot live on them.
The food articles embraced in the third and fourth groups also
contain oxygen, hydrogen, and carbon ; and to these they add nitro-
gen. This fourth component part, which forms only a small portion
of them, gives them, for some reason never explained, the peculiar
quality of producing blood and flesh. They are the raw materials,
out of which our bodies are reconstructed from day to day.
Feed a man ever so largely upon sugar, starch, gum, and oils, and
he wiU starve as certainly as if he were allowed nothing but water.
Names of Two Great Divisions of Food. — The possession or non-
possession of nitrogen, then, is what distinguishes from each other
the two great classes of food-articles. Those which contain nitrogen
HYGIENE.
75
haye been called nitrogenized, and those which are destitute of it,
non-nitrogenized compounds. As nitrogen is often called azote, the
former class are more frequently named azotized ; the latter, non-
azotized.
Let the reader now fix it in his mind that the azotized articles of
food produce blood and flesh ; the non-azotized, heat ; and he will
have the key to understand much of what is to be said, and likewise
to unlock many of the mysteries of diet.
Nutrition Table. — Taking human milk as the standard, and ex-
pressing the amount of nitrogen it contains by 100, the following
table shows the relative amount of nitrogen in the principal flesh-
producing articles of food, and consequently their power of forming
the tissues : —
Bic0 .
Rye .
Corn
Barley
Oats .
Wheat
Human Milk
Cows’ Milk .
Oyster . . .
Yolk of Eggs
Cheese . .
Eel ... .
Pork-Ham .
Salmon . .
VEGETABLE.
. 81 Potatoes 84
. 106 Turnips 106
. 125 Carrots 160
. 125 Peas 239
. 138 Beans 320
. 144
ANIMAL.
. 100 White of Egg 845
. 237 Herring 910
. 305 Haddock 816
. 305 Pigeon 756
331-447 Lamb 833
. 428 Mutton 852
. 807 Veal 911
. 610 Beef 942
Other Standards of Value. — We must not infer that those articles
which have most nitrogen are necessarily best adapted for human
diet because they are the most effective blood-producers. In deciding
the value of an article for food, other things are to be looked at be-
sides its nutritive qualities. Those which are poor in nitrogen, are
rich in carbon and hydrogen, and are well fitted to serve the double
purpose of nourishing and warming the body at the same time. The
fitness of an article for diet depends very much upon the ease or
difficulty with which it is digested and assimilated. If an article
having a great deal of nitrogen, and being very nutritive, is with
great difficulty reduced in the stomach by the digestive process, it
may be much less desirable for food than one which is digested and
assimilated easily, but is much poorer in nutritive qualities.
Heat“generating Food Articles. ^ — The reader has before him the
principal blood and tissue-forming food articles. Those which we
reckon as fuel, or heat-generators, are chiefly oils, sugar, starch, farina,
sago, arrowroot, tapioca, gums, etc. These are less essential than the
others ; for the blood-forming articles have within them the ele-
ments out of which fat is formed in the process of assimilation ; for
76
HYGIENE.
many of them contain starch ; and this, in the human organism, is
changed into fat. The amount of starch in some of these articles is
as follows : —
Wheat flour, good quality, 100, contains 65 to 66 parts in 100 pure starch.
Wheat . . . .
((
53 ‘
‘ 56
(4 it
Barley meal . .
U
64 ‘
‘ 65
ti a
Barley . . . .
U
37 ‘
‘ 37
it a
it
Rye
a
44
‘ 47
Buckwheat . .
... 108
<i
43 ‘
‘ 44
u it
it
Indian Corn . .
. . .138
n
65 ‘
‘ 66
a a
ti
Bice
n
85 ‘
‘ 86
a it
it
Peas
it
38 ‘
‘ 39
it a
tt
White Beans . .
((
37 ‘
38
it ti
it
In the Nutritive Food Articles, there is a fixed relation existing
between the elements of the tissue-formers and the heat-producers
which they contain. Out of a few of them Baron Liebig has con-
structed the following table : —
For every ten parts of blood and tissue-formers there are, —
In "Wheat flour, 10 46 In Barley, 10 67
In Rye meal, 10 57 In Rice, 10 123
In Oatmeal, 10 50 In White potatoes, 10 86
In Buckwheat, 10 130 In Blue potatoes, 10 130
Diet a Complex Subject. — From the facts and tables now pre-
sented, it appears that the question of diet is one of complexity; and
that the determination of its several points requires that a number of
things should be taken into the account. First, in deciding the use-
fulness of any article, we may inquire respecting —
Its Digestibility. — If an article be not digestible, it is of little
consequence how much or how little albumen, starch or nitrogen it
may contain. The first and most important inquiry respecting it is,
is it digestible ? If not, it is to be rejected ; for, whatever other quali-
ties it may have, it can only injure the stomach and embarrass the
whole system.
The following table will be useful to the reader, though I do not
set it down as reliable in all cases. There is often a great difference
in the ease with which different stomachs will digest the same food.
Many stomachs are afflicted with what is called an idiosyncrasy, — a
habit, peculiar to itself, of rejecting or refusing to digest some one
or more articles which are acceptable to all other stomachs. Tliis
table shows the length of time required for digesting the several ar-
ticles in the stomach of St. Martin, as shown by the experiments of
Dr. Beaumont; —
HYGIENE.
77
Articles.
Preparations.
Time.
Articles.
Preparations.
Time.
h. m.
h. m.
Eice
Boiled
1 —
Pork, recently salted
Raw
3 —
Pig’s feet, soused
Boiled
1 —
Soup, chicken
Boiled
3 —
Tripe, soused
Boiled
1 —
Oysters, fresh
Roasted
3 15
Trout, salmon, fresh
Boiled
1 30
Pork, recently salted
Broiled
3 15
(i (( ((
Fried
1 30
Pork steak
Broiled
3 15
Apples, sweet, mellow
Raw
1 30
Corn bread
Baked
3 16
Venison, steak
Broiled
1 36
Mutton, fresh
Roasted
3 15
Sago
Boiled
1 45
Carrot, orange
Boiled
3 15
Apples, sour, mellow
Raw
2 —
Sausage, fresh
Broiled
3 20
Cabbage, with vinegar
Raw
2 —
Beef, fresh, lean, dry
Roasted
3 30
Codfish, cured, dry
Boiled
2 —
Bread, wheat, fresh
Baked
3 30
Eggs, fresh
Raw
2 —
Butter
Melted
3 30
liver, beef’s fresh
Broiled
2 —
Cheese, old, strong
Raw
3 30
Milk
Boiled
2 —
Eg^s, fresh
Hard boiled
3 30
Tapioca
Boiled
2 —
Fried
3 30
Milk
Raw
2 15
Flounder, fresh
Fried
3 30
Turkey, wild
(( (t
Roasted
2 18
Oysters, fresh
Stewed
3 30
Boiled
2 25
Potatoes, Irish
Boiled
3 30
“ domesticated
Roasted
2 30
Soup, mutton
Boiled
3 30
Potatoes, Irish
Baked
2 30
“ oyster
Boiled
3 30
Parsnips
Boiled
2 30
Turnip, flat
Boiled
3 30
Pig, sucking
Roasted
2 30
Beets
Boiled
3 45
Meat hashed with )
1
Corn, green, and beans
Boiled
3 46
vegetables (
Beef, fresh, lean
Fried
4 —
Lamb, fresh
Broiled
2 30
Fowls, domestic
Boiled
4 —
Goose
Roasted
2 30
<< it
Roasted
4 —
Cake, sponge
Baked
2 30
Veal, fresh
Broiled
4 —
Cabbage-head
Raw
2 30
Soup, beef, vegeta- I
Beans, pod
Boiled
2 30
bles, and bread j
Custard
Baked
2 45
Salmon, salted
Boiled
4 —
Chicken, full-grown
Fricasseed
2 45
Heart, animal
Fried
4 —
Apples, sour, hard
Raw
2 50
Beef, old, hard, salted
Boiled
4 15
Oysters, fresh
Raw
2 65
Pork, recently salted
Fried
4 1.5
Bass, striped, fresh
Broiled
3 —
Cabbage, with vinegar
Boiled
4 30
Beef, fresh, lean, rare
Roasted
3 —
Ducks, wild
Roasted
4 30
“ steak
Broiled
3 —
Pork, recently salted
Boiled
4 30
Corn cake
Baked
3 —
Suet, mutton
Boiled
4 30
Dumpling, apple
Boiled
3 —
Veal, fresh
Fried
4 30
Eggs, fresh
Boiled soft
3 —
Pork, fat and lean
Roasted
5 15
Mutton, fresh
Broiled
3 —
Suet, beef, fresh
Boiled
5 30
Boiled
3 —
Tendon
Boiled
5 30
This table may be considered as giving a general idea of the rela-
tive digestibility of the food-articles contained in it. If not found
exactly right in each individual case, it can be rectified by experience.
The experience of no other individual’s stomach will ever be found
precisely like that of St. Martin’s, — though in its general features,
it may be sufficiently similar to make his valuable. The general
principles of conduct may be learned from the experience of others.
The particular application must come from our own experience and
reason.
Digestibility Influenced by Amount. — The rapidity with which
any article is digested will vary with the amount taken. A larger
quantity than is called for by the wants of the system will be di-
gested more slowly than the proper amount ; whale, on the other
hand, an insufficient supply begets an inability to reduce in the
stomach even the small quantity taken. We may err in taking too
78
HYGIENE.
little food as well as in taking too much ; though the former error is
much less likely to occur than the latter.
Choosing Food in III Health, — But in deciding the kind and
amount of food we must be guided not only by its digestibility, but
by the state of the health.
If we find the stomach apparently in good working condition, capa-
ble of dissolving properly whatever is submitted to its action, and
yet we are for some cause losing flesh and strength, we should resort
not only to the most nutritious of the albuminous group of the azo-
tized articles, but likewise to the oleaginous group of the non-azo-
tized. We want a great amount of nutriment, and we need oils to
make fat. This is the kind of food generally wanted in constitu-
tional consumption.
In fevers, but little food can be disposed of at best ; and that little
must be chosen with reference to its mildness and its unstimulating
qualities. Generally the farinaceous or starchy articles are most
suitable, because they have no stimnlating and irritating qnalities,
and especially because they furnish fuel to be burned with oxygen,
and thus take the place of the animal tissues, which are being rapidly
consumed with this devouring element. In fever, oxygen is literally
burning up the body. In this state of the system, this element ac-
quires, by some means, a singular affinity for the tissues ; and, unit-
ing with them rapidly, forms a true combustion. The physician who
throws to this devouring agent some of the mild, non-azotized articles
which offer it stronger affinities than it finds in the tissues, is as wise
as he who tosses his dog to a hungry lion to avoid being devoured
himself.
Exercise to be Considered. — In deciding the diet, the amount of
exercise is not less important to be considered than the health. The
farmer, who works in the open air, and uses his muscles a great deal,
wants considerably more nutritive, as well as more combustive, food
than one who leads a sedentary life. Of course there is a great deal
more waste of the tissues, and he requires more of the flesh-forming
articles ; and as he breathes deeper, and takes in more oxygen, he
needs more of the supporters of respiration, — the sugars, oils, and
starchy aliments.
Beans. — By turning to the table which shows the amount of nitro-
gen in the different food-articles, the reader will see that beans are
rich in this element. They are, therefore, excellent food for working
men, who are obliged to make great use of their muscles. Our
fathers, who broke and subdued the rocky soil of New England,
showed wisdom even in their instincts in taking so large a portion
of their aliment from the bean, — especially as they oiled it with the
fat of pork. But for the hard-working student^ who daily makes
heavy drafts upon his brain and nervous system, beans and peas are
an improper diet. They contain no phosphorus^ in the shape of
HYGIENE.
79
phosphate of lime ; and no brain can work hard without a due supply
of phosphorus, which forms a part of its substance.
Unbolted Wheat Flour, — For the man who uses his brain a great
deal, there is no other one article of food equal to bread made from
unbolted wheat flour. Fine wheat flour is little better for him than
beans, because the miller has robbed it of much of the phosphorus,
which is found chiefly in the hull or bran.
I mention only two or three articles of food as specimeiis. By
looking over the tables furnished, and reasoning upon the whole in
the way I have done upon these few, the reader can give every arti-
cle something like its proper value in most circumstances.
Climate. — If health and exercise should influence us in choosing
the kind and the amount of food, climate must do so quite as much.
In the frigid climate of high latitudes, it is necessary that a great
deal of heat be produced in the body, in order to avoid perishing
with cold. There \s no mystery now, as there once was, about the
production of this heat. It comes from the burning of carbon and
other substances in the body, where they unite with oxygen, and
make just as real a fire as that which warms our houses. Oils, sugar,
starch, gums, etc., are largely composed of carbon, and readily unite
with oxygen in the body. This is the reason they are reckoned as
fuel, and are called supporters of combustion. And for this reason,
they require to be largely consumed in very cold climates. The in-
stincts of men seem to lead to the same conclusion, for the dwellers
in all high latitudes consume great quantities of oils and fats. The
amount of train-oil, tallow, the fat of seals and other animals, devoured
by the Laplanders, Kamtschatkans, and other northern people, is truly
wonderful.
In hot countries, the fundamental rule for preserving the health is
to keep the body cool. Without observing this rule, the strongest
will often fall victims to the climate in low latitudes. But to keep
cool, of course all the heat-producing articles of food should be
avoided. Particularly all alcoholic drinks, which are powerful sup-
porters of combustion, should be rejected. Rice and the various fruits
form the most suitable articles of diet.
The great sacrifice of life witnessed among the early emigrants to
California, was the result chiefly of using ardent spirits and heat-
producing food while crossing the Isthmus, which, to a northern
constitution, is much like a vast oven, heated to a temperature suit-
able for baking bread. There are few persons, with tolerable health
and strength, but could safely endure the hottest climate if they
would avoid alcoholic liquors and confine themselves to an abstem-
ious vegetable and fruit (Ret.
Bayard Taylor’s Opinion. — The distinguished traveller, Bayard
Taylor, reports that while spending a few days in a heated part of
Africa, he lived as the inhabitants did, pretty much entirely upon the
80
HYGIENE.
flesh of well-fatted sheep ; and that he enjoyed, meantime, excellent
health and strength. From this he concludes that animal food is as
suitable in hot climates as in cold.
It is a pity a man of such excellent parts as Mr. Taylor should
have allowed himself to rear so tall a structure upon so narrow a
foundation. That he could live on flesh in so hot a region, and not
be made sick, only proved that he had a fine constitution, and that
his health was not easily disturbed ; and when he attempted, from
his limited experience of a few days, to reason against the established
facts of science, and against the well-attested laws of life, he did it
evidently without reflecting that he was in a field of thought which
he never had occasion to cultivate.
The great Jewish Lawgiver doubtless had a reason for prohibiting
pork to the Jews. Whatever that reason was, the prohibition had a
wise bearing upon the health of the people. Palestine has a hot
climate, in which pork-fat is an improper diet.
More Fat in Winter, — It follows from what has been said, that a
more fatty as well as stimulating diet is needed in winter than in
summer. But the change should be made gradually. When cold
weather approaches, the food should become more nutritious and
warming by little and little. The exercise should likewise be in-
creased.
Even the lower animals act upon this plan. In the fall, squirrels
eat nuts, which are full of oil, and grow fat upon them.
The instincts of men move in the same direction. It is in the fall
that the hog, the ox, and the poultry are killed ; and in the winter
that they are largely feasted upon and enjoyed. Upon such food,
combined with various sorts of starch, man fattens ; and a good sup-
ply of fat, deposited in the cells, is equal, in keeping out cold, to a
layer of cotton batting, — to say nothing of the fire kept up within
the body by the burning of such fuel. As hot weather comes on, we
gradually lay aside these fattening articles (or ought to), and return
to the watery vegetables and fruits, such as squash, string-beans,
strawberries, currants, etc.
Few of us, I apprehend, would suffer from heat in summer, if we
could persuade ourselves to abandon stimulating and fire-producing
food, and confine ourselves pretty much to a cooling and succulent
diet. Diarrhoeas in summer are not induced by eating wholesome-
vegetables, but by combining them with large quantities of animal
food.
The State of the Mind. — This should by no means be over-
looked in choosing the kind and the amount of food. If we have
lost friends, or heard desponding news, or experienced calamities of
any kind, we must, during the first hours of the shock, or even during
the first days, if the affliction be heavy, partake very sparingly of food.
The stomach is in no condition to receive it. The brain lies pros-
HYGIENE.
81
trate under the stroke, and the stomach, in sympathy with it, asks
for a day of sorrow and fasting. Disturb it not.
Heat“producing Food Incompatible with Excitement. — It is
folly to take heat-producing aliment when laboring for days under
high excitements. During political campaigns, when the blood of
politicians is at the boiling point, the diet should be unstimulating,
— containing very little animal flesh, and not much combustive food.
Many a man has died of apoplexy, or of heart-disease, by putting on
the steam when his blood was up. Whenever we have a day of un-
common excitement to pass through, we should always begin and
end it with an unusual degree of abstinence as to the amount of food
taken, and with special care that the articles be of the highest kind.
Anger Demands Abstinence. — Anger is a passion which espe-
cially unflts the stomach for doing much work. If it occur often, or
be protracted, but little food should be taken. Those who indulge it
have a double cause for abstinence. Both their folly and their stom-
achs call for a fast.
Food Adapted to Different Periods of Life. — Food must vary in
different periods of life. The infant needs a fattening diet ; and this
has been supplied in the milk of the mother, which contains more
butter (the fattening portion) than the milk of any other animal.
But as the infant has much less exercise than the young of animals,
its flesh is not wasted, and it does not require so much azotized food,
that is, the reader will remember, food with nitrogen in it. Accord-
ingly, it will be seen by looking at the table on page 7 0, that human
milk has much less of this element than that of the cow. As the
child grows up, and begins to take active exercise, indoors and out,
it wants more solid food, and teeth make their appearance to masti-
cate or chew it.
In Youth and Hanhood, the great amount of exercise usually
taken calls for larger supplies of azotized aliment, — beef, mutton,
pork, fowl, fish, wheat-flour, corn-meal, rye-meal, potatoes, turnips,
peas, beans, etc. This is the working part of life, when the tissues
are rapidly wasted by action, and the flesh-forming aliments are
wanted to keep them good.
In Old Age, the exercise is diminished, the blood circulates more
slowly, and the body grows cold. Now is the time to resort to non-
azotized food, — oils, fats, the various kinds of starch, sugar, and the
like. These will furnish fuel to warm the sluggish blood, and will
invest the body with fat, which will serve the purpose both of a cush-
ion and a garment. Wine, beer, porter, and distilled spirits are never
needed by young persons in health ; but the aged are frequently bene-
fited by them, if taken in small quantities. They are chiefly com-
posed of oxygen, hydrogen and carbon, and are properly ranked with
82
HYGIENE.
the supporters of combustion. They are likewise stimuiant, and add
to the comfort of the old by quickening their circulation. Like tea
and coffee, they diminish the waste of the body, and thereby lessen
the demand for food.
The smallest amount of aliment upon wliich a healthy adult person
ever lived for any length of time, was twelve ounces a day. Upon
this small daily allowance, Lewis Cornaro, a noble Venetian, sub-
sisted in perfect health, during the protracted period of fifty-eight
years. This he was able to do only by adding daily to his food
about twelve ounces of light wines. I shall have occasion to refer
to tliis case again.
Cost of Food.
One other consideration must ever influence the great majority of
men in selecting their food. I mean its cost. It is a matter of great
importance to the poor, to know what kinds of food they can subsist
upon with least expense. Sometimes provisions are so high that
persons in poor circumstances greatly need advice in this matter.
Let me endeavor to furnish some information which shall be of ser-
vice to the reader.
Milk is supplied by nature to be our first food, and is a good type
of all alimentary substances. It contains
curd, which has nitrogen, and is equivalent
to albumen and fibrin, and represents the
blood-formers. It has butter and sugar.
These represent the heat-formers. It has
salts, which contain potash, soda, phospho-
rus, etc. Fig. 64 is a microscopic view of
good milk ; Fig. 65, of poor milk ; and Fig.
66, of milk adulterated with calf’s brains.
Food will be valuable in proportion as
it combines, in due proportion, the articles
contained in the four groups, represented
by albumen, fat, sugar, and salts.
Albuminous Group. — Albumen, fibrin, casein, and gluten, all en-
ter into the substance of animal and vegetable bodies, and are all
composed of the same elements, namely, 48 parts carbon ; 36 of
hydrogen ; 14 of oxygen ; and 6 of nitrogen. In containing nitrogen
they all differ from the other three groups. Albumen being a good
type of them, they are called albuminous compounds. Albumen
forms a large portion of the serum, or colorless part of the blood.
It is the leading principle in alimentation. It is worked up into the
tissues of our bodies. It forms our muscles, our membranes, a por-
tion of our nerves, etc. It is the bricks of which the house we live
in is made. All the articles, therefore, which are chemically consti-
tuted like it, may well be termed albuminous.
HYGIENE.
83
These bodies, consisting of the four organic elements named above,
have been called quaternary compounds. Besides these elements, they
have a minute portion of sulphur and phosphorus. They are also
called protein or proteinaceous compounds.
Albumen is a very unstable compound, — tending strongly to de-
composition. This is owing to the complexity of its composition,
and to its union with the fickle element, nitrogen, which forms chemi-
cal compacts reluctantly, and breaks them without remorse. Sub-
stances which coagulate or fix albumen in an insoluble compound,
or preserve the tissues of the body, which are made from it, from
decomposition or putrefaction, are called antiseptics.
Fatty Group. — The next group, represented by fat, performs very
important offices in the system, — the most important of which is a
union with albumen in the formation of cells. All animal and vege-
table life begins with the cell, — the tiny cup, with which nature dips
all the streams of life out of the great fountain of inorganic matter.
No cell is formed without a minute particle of oil. The portion not
used in forming cells, is either burned as fuel to keep us warm, by
uniting with oxygen, or it is stored away in the cellular tissues, add-
ing to the hulk of the person. If, then, the very beginnings of life
are dependent upon fat, it is of great importance as an article of diet.
So necessary is it in the economy of life, that when not taken in the
food, it is formed out of albumen in the processes of assimilation.
The Starch and Sugar Group, composed of several kinds of sugar,
gum, etc., is never used in forming the tissues, but they perform im-
portant offices in the changes going on within the human organism.
Thus, sugar of milk is decomposed, and forms lactic acid, so called
from being found in sour milk. This acid plays a very important
part in the process of nutrition.
Pure starch is a snow-white powder, having a glistening aspect.
It is composed of grains from to of an inch in diameter in
the different grains ; being largest in the potato and smallest in
wheat. When examined with the microscope, they appear as in Fig.
63.
84
HYGIENE.
The Salts Group are sufficiently spoken of in another place.
A wise philosopher in ancient time said, “ I do not live to eat and
drink ; I eat and drink to live.” If we intend to eat to live, we must
combine, in our food, the four groups above explained ; and if we
would live at as small expense as possible, we must take those arti-
cles which are low in price and rich in nutritive matter. The fol-
lowing table will help the reader make his selections : —
Table of the relative value of articles of food arranged according to their proportions of
nutrient matter in each of the four groups of elements concerned in vital changes.
In 100 pounds of
Husk or
woody fibre.
1st Group.
Albuminous
substances.
2d Group.
Fats.
3d Group.
Starch and
Sugar.
4th Group.
Salts.
Grains :
Wheat
15
15
10 to 19
2 to 4
55
2
Barley
15
15
12 to 15
2 to 3
60
3
Oats
16
20
14 to 19
5 to 7
60
4
Bye
12
10 to 20
10 to 15
3 to 4
60
2
Indian Corn
14
6
11
8.1
74
li
Buckwheat
15
25
8
0.4
50
4
Bice
13
3
7
0.7
79
Oi
Pod Plants:
Beans
14
Stoll
24 to 28
2 to 3
40
3
Peas
14
9
24
2.1
50
3
Boots :
Potato
75
4
2.1
0.3
18
1 to li
Turnip
88
2
1.5
0.3
9
1 to 425
Carrot
85
3
1.5
0.4
10
li to 2
Beet (mangold wurzel)
85
2
2
11
f to 1
Long red
85
3.03
0.48
10.36
li
Short red
85
3.31
0.26
12.46
.75
Sugar beet
85
2
0.35
13
Parsnip
80
125
2.5
16
i
Leaf:
Cabbage
30 to 35
Meal:
Wheat flour
15
10.8
2
70.5
Byemeal
15
4.63
8
2
73
2
Barleymeal
15
6.3
2.4
74
2
Oatmeal
15
12.6
5.6
64
3
Wheat bran
13.1
55
19.3
4.7
.6
7.3
The following tables have an admirably practical bearing upon
economy in food ; —
100 lbs.
Muscle-
forming
Elements,
in lbs.
Fat-forming
Elements,
in lbs.
Relative Propor-
tion of each,
in lbs.
Husky, or
Woody fibre,
in lbs.
Barley
14
64
Ito 4J
15
Beans
26
42
1 to l|
10
Beets
2
12
1 to 6
(?)
Buckwheat
8
54
1 to 6|
25
Carrots
li
10
1 to 6|
3
Corn
12
77
1 to 6j
6
Oats
17
66
1 to 4
20
•Peas
24
52
lto2i
8
Potatoes
2
19
Ito 94
4
Turnms (field)
li
9
Ito 6
2
Do. (Swedish)
2|
12
1 to 54
2
Wheat Flour
11
79
1 to 7
Wheat Bran
18
6
1 to 4
55
Cheese (whole milk)
28.4
51.1
1 to 1|
Cheese (skim-milk)
49.8
6.3
1 to 4
HYGIENE.
85
Articles.
Cost.
Muscle-producing
Elements.
Cost of Moscle-pro-
ducing Elements.
Barley . . . :
$1.00 per bn.
8.4 lbs.
12c. per lb.
Beans
1.80 “
16.6 “
11c.
i<
Corn
0.50 »
6.7 “
7jc.
U
Oats
0.35 “
5.2 “
7c.
<i
Peas
1.00 “
14.3 “
7c.
n
Potatoes
0.85 “
1.6 “
53c.
Turnips
0.50 “
1.2 “
41c.
<<
Flour (fine)
5.00 per bbl.
22.0 “
23c.
u
Flour (unbolted)
4.50 “
24.8 “
18c.
(<
These tables will well repay study, for their practical use will save
many dollars to the poor. Let it be remembered that producing
muscle is the same thing as producing strength, or labor-power.
Bearing this in mind, the following table will be very interesting : —
One pound of labor-power from Potatoes costs 53c. per lb.
Fine Flour,
23c.
Unbolted do., 18c.
Turnips,
41c.
Barley,
12c.
Corn,
7ic.
Beans,
11c.
Peas,
7c.
Oats,
7c.
Meats are omitted in the table. So far as their nutritive qualities
are concerned, it is of little consequence which are taken. Some are
more digestible than others, and this consideration should influence
those with weak stomachs in selecting. Every person, of course,
knows their relative cheapness.
Among the vegetables given in the table, there is a wider range
for choice. Let us consider them in course.
Wheat. — In this, the four groups are represented in excellent
proportion. When not deprived of the bran, it is perhaps the very
best supporter of animal life. So high have been the regards of men
for it, and so generously have they awarded to it their acknowledg-
ments, that its product, bread, has been everywhere called “ the staff
of life.” The settlement and cultivation of the immense prairies of
the West have within recent years so increased the production of
wheat, that its cost is now less than half what it was fifty years ago,
and it is indeed within the means of all in America.
Barley. — This has the four groups 'represented in nearly the same
proportions as wheat. It is, therefore, nearly as valuable an alimen-
tary grain. Unfortunately it is not so toothsome as wheat, and can
never be so popular an article of diet. The Scotch, however, feed
upon it with apparent relish, and doubtless think it strange that for-
eign palates are not better pleased with it.
Oats. — This grain, strange to say, has more albuminous, or nutri-
tive matter, more fat, more starch, and more salts than wheat. In
uniting a large quantity of the four alimentary groups, it surpasses
86
HYGIENE.
every other vegetable substance. In albumen, it is not quite as rich
as peas and beans, and in starch it falls a trifle below fine wheat
flour ; but in fat it is exceeded only by Indian corn. This grain is
likewise consumed largely by the Scotch, — a people whose claims to
shrewd common sense are well supported by, as their hardy constitu-
tions vindicate, the choice. This grain might well be permitted to
take the place of rice. It affords several times as much nutriment,
while it costs only about one-fifth as much. There is good reason
why the horse should thrive upon oats. Most stable-keepers think
their horses will do more work upon corn-meal, but this must be a
mistake. In using oats for horse-feeding, a large portion of the nu-
triment is lost by not grinding them.
Rye. — This is also a grain of considerable nutritive value. It is
much cheaper than wheat ; and rye meal has long been a standard
article of diet in New England, — particularly in connection with
Indian meal, as “brown bread.” It is useful for relieving costive-
ness, in the form of “ hasty-pudding,” with molasses.
Indian Corn. — This staple article of American produce needs no
praise from me. It is comparatively cheap, nutritive, and wholesome.
It abounds in fat and starch, and has a fair amount of albumen,
though not as much as the oat, the barley, or the wheat. In salts, it
is rather deficient. Indian corn is strictly an American plant, and is
perhaps the most popular grain in the country. It has emphatically
a national reputation, and is perhaps worked up into more savory
dishes than any other. At the South it is an institution. It is there
made into hoe-cake, corn-cake, batter-cakes, batter-bread, muffins, corn-
pone, etc. At the North, we have johnny-cake, Indian and pumpkin-
cake, baked Indian pudding, boiled Indian pudding, beside the well-
known rye and Indian bread, and other preparations. Give an in-
genious Southern or Northern housewife a few simple adjuncts, such
as lard, milk, sugar, eggs, cream of tartar, and soda, and she will
make a pretty respectable larder from this single grain. If molasses
be substituted for sugar, and a little stewed pumpkin be thrown in
by way of garniture, we may have several preparations which are
very nourishing as well as cheap.
Buckwheat. — Poor in nutritive matter, fat, starch, and sugar, but
tolerably well supplied with salts. It will do very well for batter-
cakes in winter. When brought smoking upon the table, and served
with sugar or molasses and butter, these cakes are a luxury, in which
the rich may indulge if they choose ; but for the poor, the amount of
nourishment they afford is too small for their cost.
Rice. — Much like buckwheat, except that it has more fat, sugar,
and starch, and less salts. As an article of diet, it has had too high
a reputation. Those who would live on small means cannot afford
it. Boiled in plain water, it is excellent for a relaxed state of the
bowels ; and this about all the commendation to wliich it is entitled.
HYGIENE.
87
Beans.— The richest in nutritive matter of all vegetable substances,
except cabbage and oats. They have more albumen than wheat, or
corn, or barley, or oats ; but in fat and starch they are lower in the
scale. Add to them salt pork, and the highest of all nutrient com-
pounds is obtained. During not less than four generations, pork
and beans, as the principal diet, nourished an iron-sided race of men
in New England. Bean-porridge was like honey upon the tongue of
the founders of New England institutions. They ate it morning,
noon, and night ; and thanked God for it every time. And well they
might thank Him ; for, with Indian corn, it furnished them with a
diet better adapted to their condition than any other.
Peas. — Not quite as rich as beans in albumen, but more rich in
starch, is of about the same value on the whole. The Canadian French,
in Lower Canada, feed on peas to about the same extent that the
New Englanders did on beans. Pea-soup, as prepared by the best
cooks among them, is a dish of great nutritive excellence ; and, in
my judgment, more palatable than bean-soup.
The Potato. — Three-quarters of this root is water, and it is poor
in all the elements of nutrition. It is a palatable article, and most
persons are much attached to it. As hulk is of some consequence in
food, the potato is not without value. Men do not often live entirely
upon potatoes, — not even in Ireland. Milk, butter-milk, and espe-
cially cabbage, are united with them.
Turnips, Carrots, Beets, Parsnips. — These are much alike, —
being all poor in nutritive qualities. They serve to please the pal-
ate by furnishing a variety ; but in our city markets they are expen-
sive, and do not furnish an economical diet.
Cabbage. — It is interesting to observe how the instinets of men
have in all ages led them to select those articles of diet which their
circumstances have demanded. The poverty of the Irish has led
them to subsist largely upon the potato, — a root which the soil of
their country yields profusely. But as this root has but little nutri-
tive matter, necessity required that it should be united with some
other vegetable. The natural instinct selected the cabbage ; and
when chemical science came, at length, to pass judgment upon the
correctness of this instinct, it turns out that the cabbage is the richest
in albumen of any known vegetable. The cabbage, then, is the nat-
ural complement of the potato ; and the Irish had the sagacity, with-
out science, to bring the two together. It is said the Irish have a dish
named “ kohl-cannon,” consisting of boiled and mashed potatoes and
cabbage, seasoned with pork fat, pepper, and salt, and that it is a
truly savory dish. It certainly is a nourishing and a cheap one. The
ambassador who was sent to tamper with the patriotism of a Roman
who had dined on beans, was asked if he was silly enough to think
gold and silver could bribe a man who was satisfied with so plain a
88
HYGIENE.
fare, and desired no other. We come to the conclusion then, that
bean-porridge, pea-soup, suet-pudding sweetened with molasses, oat>
meal, and barley-bread, with “ kohl-cannon ” for those who can digest
it, will furnish, for hard-working men, the most substantial diet, at
the smallest possible expense. To render these dishes savory, and
to make the table on which they are spread an inviting board, the
deft housewife must employ her best skill in serving them. With
the thousand “ fixings, with which a New England matron knows
how to garnish them (or would know how if they came within her
cuhnary operations), they are well fitted to leave savory impressions
upon tongues which would praise them to the end of life. I speak
of these articles as furnishing a cheap diet for working men. The
indolent, the sedentary, and the effeminate from various causes, could
not digest them.
The Amount of Food Taken.
We have already explained that this should be governed, in part,
by the amount of exercise taken, by the condition of the health, by
the state of the mind, by the climate, by the season, etc. It remains
to add a few words in a general way, respecting the absolute amount
required by an adult man.
It is plain enough that most men eat too much. We come very
near, in this country, being a nation of gormands. A principal rea-
son of our over-eating is, that we eat so fast. When the food is well
and slowly masticated and swallowed, the gastric juice has time to
mix with it ; and at the proper moment the appetite ceases. But
when our food is bolted rapidly, nature, finding her laws disregarded,
and all her purposes frustrated, stands back, and lets us learn to stop,
too late, alas ! from a sense of fullness in a stretched and abused
stomach.
It has already been stated that Lewis Cornaro lived fifty-eight
years, namely, from the age of forty-two to one hundred, on twelve
ounces of solid food a day, with about the same amount of light
wines. At the age of eighty-four he wrote a book, in which he
praises “divine temperance” in terms which are sometimes eloquent
and often enthusiastic. Indeed it is very rare that a man at that
age retains such clearness of intellect, and especially such freshness
of feeling as he evinces in his book. Probably but few could live on
the amount of food which he found sufficient. Yet it is said the
distinguished John Wesley lived on sixteen ounces a day, which, as
he took no wine, and had to derive the combustive materials for
warming the body from the food, was quite as scanty a fare as that
of Cornaro. Considering that he led a most extraordinarily active
life, both of body and mind, being half his waking hours in the sad-
dle and preaching almost daily, this is probably the most remarkable
case of abstemiousness on record. Jonathan Edwards did not, I
think, exceed the same amount of food, but he was not so active a
man.
HYGIENE.
89
Putting aside such exceptional cases as these, we may say in round
numbers, that a laboring man requires, to keep him in health, about
two or two and a half pounds of solid food per day. For ministers,
lawyers, doctors, authors, and merchants, one pound and a half is
amply sufficient. The amount should be increased a little by a se-
lection from some of the fuel-formers, if no fermented or alcoholic
drinks be taken, and slightly diminished if they are used. The rea-
son is that these drinks furnish fuel to be burned in breathing,
which has to be drawn from the food when they are not employed.
This furnishes no motive for using ardent spirits ; for there is fuel
enough to be had in the oils, starches, and sugars.
Dyspeptics. — It is said that dyspeptics eat more than persons in
health ; and, in many cases, the remark may be true. The appetite
of a person suffering from this disease is almost always morbid, and
the information it gives respecting the real wants of the system can
seldom be trusted. If we allow a diseased stomach to dictate to us
when and what and how much we shall eat and drink, our misery
for life is a foregone question. A sick stomach is like a spoiled child,
— it cries for what it should not have. If the dyspeptic will live,
and enjoy any amount of peace and comfort, he must follow this
simple rule : To eat no more than can he digested, even though the
amount he only an ounce a day.
Animal and Vegetable Food.
It has generally been supposed that it was intended man should
subsist on a mixed diet, consisting of both animal and vegetable
substances. Within the last fifty years, however, a school of physi-
ologists have appeared, who affirm that a vegetable diet is alone
consistent with the laws of health. They declare that animal food is
not adapted to man’s organization, — that it unduly stimulates the
blood, predisposes to fevers, consumptions, diarrhoeas, choleras, apo-
plexy, and numerous other diseases, and of course shortens life.
That such a school should have come into existence in this country,
where animal food is more largely consumed than in any other part
of the world, in proportion to the number of people, is not surprising.
We do, undoubtedly, eat too much flesh. So enormous is the consump-
tion, that notwithstanding the vast herds of cattle raised in all our
agricultural states, and especially on the western plains, the demand
keeps up with the supply so well that beef brings, on an average,
about twenty cents per pound, — at least twice its full value as a
blood-former.
Facts show that man may live upon flesh alone, upon vegetables
alone, or upon flesh and vegetables combined. Is it best he should
subsist upon vegetables only, or upon a mixed diet? A mere affirm-
ation upon these points is of little consequence. To cite facts avails
nothing. Men have a way of maldng their own affirmations, and of
90
HYGIENE.
looking at facts with eyes wliich sometimes see elearly enough on
both sides of them, but totally ignore their existence.
Man’s Structure Settles the Question. — To settle this matter, we
must appeal to man’s organization. His structure will tell us some-
thing we need not mistake. All the works of God show design.
Everything he has made has a use, and is so contrived as to be
adapted to that use. Lions, tigers, and other animals, for example,
which feed on flesh alone, have a short second stomach, — it being
only about three times the length of the animal’s body. Animals
which eat no flesh have a long second stomach, — that of the sheep
being from thirty to thirty-five times the length of its body. A very
remarkable difference of anatomical structure!
Tins is the meaning of the difference : Vegetable food has a great
deal of waste matter in it. Woody fibre makes quite an item in its
composition. This waste portion must be carefully separated from
the nutritive part, and this must all be done in the second stomach.
It takes time to do it. It must not be done in a hurry. The nutri-
tive materials are destined to build a living structure, whose dura-
tion, like that of all other fabrics, will depend on the care with
which the materials are selected and put together. The second
stomach of the sheep is long, that there may be ample time for the
mixed mass of chyme, when it passes out of the first stomach, to be
changed to chyle, and then to be carefully separated into the two
parts, the useful and the useless. Animal food is in its composition
just like our own flesh, — there is little waste matter, and not much
time is required for its separation ; hence, the second stomach of
flesh-eating animals is short. Nearly the whole alimentary mass is
quickly taken up by the lacteals, and there is no occasion for its
travelling through a long second stomach.
Man's second stomach is in length midway between that of the
flesh-eating and the vegetable-eating animals. If there be design in
the works of the Creator, and if that design in the structure of the
flesh and vegetable-consuming animals has now been correctly inter-
preted, it is plain that man is best nourished when he eats both kinds
of food. The structure of his teeth and the motions of his jaws
(see p. 30), confirm the same conclusion.
Americans Eat too Much Meat. — Yet, as I have said, there is no
doubt the Americans eat too much meat. Sedentary persons require
but very little. Less is wanted in summer than in winter, — in warm
climates than in cold. People of wealth, whose circumstances im-
pose no bodily hardships, need less than the poor, who are much
exposed, and work hard; whereas, they consume more. Those who
do not labor with their hands, should never taste meat more than
once a day.
It is painfully-amusing (if such a compound word is admissible)
to hear a nervous female, whose sole exercise consists in going from
HYGIENE.
91
the parlor to the kitchen once or twice a day, and in making a briei
shopping excursion once a week, complain that she cannot maintain
her strength unless she eats freely twice a day of meat, and takes her
free potations of strong coffee and wine.
A like opinion prevails generally among the feeble who are not
obliged to labor. The child in its nurse’s arms must daily, it is
thought, suck a piece of chicken or beefsteak in order to thrive.
Children thus fed have their blood constantly inflamed, and stand a
poor chance when attacked by scarlet fever. The little master or
miss who attends school complains of headache, and grows pale,
feeble, and nervous. The books are blamed and thrown aside for
what the dishes have done. The doctor is called in and assured
that the dear child can cat nothing but a little fat broth, a custard,
or cake ; and if he presc ibe a diet of plain bread and milk, he is
believed to be heartless, r nd his prescription is not followed.
The Majority of Mankind Eat no Flesh. — All such misguided
persons should be apprizec that the great majority of mankind eat
no flesh, because they cannot afford it. And they do not appear to
suffer from its loss. Millions of Irish do not taste of flesh or fish
from one month’s end to another. Potatoes, oatmeal, and cabbage
constitute their chief diet. Rice, poor as it is in nourishment,
sustains, when combined with vegetable oil, millions of people in
Asia. The Lazaroni of Naples, with active and finely moulded
forms, live on bread and potatoes. These facts do not afford ground
for altogether rejecting animal food, any more than Bayard Taylor’s
statement respecting whole tribes in Africa who live upon flesh
furnishes a reason for excluding vegetable aliment. Man may live
and enjoy health upon either, but his organization implies the use
of both.
Proportions of Animal and Vegetable Food.
Upon this subject, it is impossible to fix any absolute rules. This
is a point which must be determined by the temperament, the state
of the health, the constitution, etc. Persons of a scrofulous habit
should eat freely of animal food. But an inflamed stomach should
never be tormented with flesh. Meat is stimulating, and will be
almost sure to do mischief when there is heat and tenderness at the
pit of the stomach. There are cases of inflammation of this organ,
in which it may be necessary to live on bread and milk, with articles
of the starch group, for months, and even for years.
On the other hand, when the system has run low from some
exhausting disease, which excites no feverish action, it may be
necessary at times to take a diet almost exclusively animal.
It is absurd to talk of the same diet as adapted to all persons, even
when in health. As well might we expect one shoe to fit every
foot, or one coat every back, or one color every eye, or one doctrine
every mind.
92
HYGIENE.
Temperance the Main Thing. — After all, the great thing to be
aimed at is temperance. It is not so necessary to reject one article
and use another, as to partake of all with moderation, “ I do not
live to eat and drink ; I eat and drink to live,” said a wise philoso-
pher of the olden time. One would think the moderns have
reversed this rule. A modern table has the appearance of being
spread for the purpose of inducing men to eat all their stomachs will
hold. A man who can dine daily, for half a dozen years, at one
of our firskclass hotels, and then find himself free of dyspepsia and
all other diseases, must have a fine constitution, as well as most
admirable control over his appetite. Mr. Addison said, “ When I
behold a full table set out in all its magnificence, I fancy I see
gout, cholic, fevers, and lethargies lying in ambuscade among the
dishes ” ; to which he adds, with much truth, in another place,
“ Abstinence starves a growing distemper.”
Good Results of Temperance. — A temperate diet has always
been attended with excellent results, and always will be. There are
times of great anxiety, when abstinence should be pushed to the
extreme verge of endurance. During the siege of Gilbraltar, Lord
Heathfield, its gallant defender, lived eight days on four ounces
of rice per day. Dr. Franklin, when a journeyman printer, lived
two weeks on bread and water, at the rate of ten pounds of bread a
week, and was stout and hearty. Dr. Jackson, an eminent physician
in the British army, says, “ I have wandered a good deal about the
world, and never followed any prescribed rule in anything; my
health has been tried in all ways ; and, by the aid of temperance and
hard work, I have worn out two armies, in two wars, and probably
could wear out another before my period of old age arrives.”
Lord Bacon was right in the opinion that intemperance of some
kind or other destroys the bulk of mankind, and that life may be
sustained by a very scanty portion of nourishment. Cornaro, whom
I have before mentioned as having lived fifty-eight years on twelve
ounces of solid food a day, wrote as follows respecting himself in
his eighty-fifth year : “ I now enjoy a vigorous state of body and
of mind. I mount my horse from the level ground ; I climp steep
ascents with ease ; and have written a comedy full of innocent mirth
and raillery. When I return home, either from private business or
from the senate, I have eleven grand-children, with whose education,
amusement and songs I am greatly delighted; and I frequently
sing with them, for my voice is clearer and stronger now than ever
it was in my youth. In short, I am in all respects happy, and quite
a stranger to the doleful, morose, dying life of lame, deaf and
blind old age, worn out with intemperance.” Howard, the philan-
thropist, fasted one day in the week ; and Napoleon, when he felt his
system unstrung, suspended his meals, and took exercise on horse-
back.
Nothing can be plainer than the duty of fasting, when the
stomach, having been overworked, is disinclined to receive food.
HYGIENE.
93
Brutes invariably follow this suggestion of nature ; they never eat
when sick, — probably because they have no silly nurses to coax
them to swallow stimulating aliments. The habit of putting high-
seasoned food into the stomach when it is inflamed and feverish is
about as wise as directing streams of blue, violet, or red light into
the eye when it is red and swollen with inflammation.
Tea and Coffee.
It is proper, before closing this chapter upon diet, that something
should be said respecting the beverages of tea and coffee.
Some years ago, a meeting was held by the leading physicians
of a city in the old world, in which the merits of tea and coffee were
discussed. In this discussion each man first stated his experience
in the use of these articles, and then constructed his argument
according to that experience. The amount of what the reader could
learn from the discussion was that Dr. A. had used tea all his life,
and been benefited by it, while coffee had uniformly injured him ; and
that he thought tea should be used, while coffee should be rejected ;
that Dr. B. had taken coffee at breakfast, and found it an excellent
support to the stomach and nervous system, while tea had disturbed
his digestion and his mind ; and that the former was a beverage
of excellent qualities, while the latter was detestable ; that Dr. C.
had always drank both tea and coffee, and recommended them to
everybody ; and that Dr. D. had himself never been able to indulge
either tea or coffee, and would have them both expelled from every
household. ^
The discussion was not creditable to the learned and really able
men who participated in it. The arguments were all based upon the
miserably narrow basis of single individual experiences. They were
no more valid than that of the man who should hold up a shoe, de-
claring it fitted his foot the best of any he ever had, and recommend-
ing all men to have their shoes made upon the same last.
The truth is, there is but one thing which can be affirmed univer-
sally of the effect of tea and coffee. They both, when taken, tend to
prevent waste in the body, and, consequently, less food is required
when they are used. This may be affirmed of them in their applica-
bility to all persons, but nothing further. The truth is, some can
drink tea but not coffee, and some coffee but not tea; some can use
both, and some neither. Every man’s susceptibility to the effects of
these beverages is his own, as much as his susceptibility to the effects
of light, or heat, or atmospheric changes; and these effects, each per-
son must learn from experience. Coffee often produces, and gener-
ally aggravates, a bilious habit, — an effect which cannot, I believe,
be traced to the use of tea. I have no doubt but that many cases of
confirmed dyspepsia are traceable to the use of coffee alone.
94
HYGIENE.
Water.
There is one universal beverage ; it is water. All men are fond
of it. In sickness and in health, in joy and sorrow, in summer and
winter, in cold climates and in hot, man loves and drinks water. The
stomach, abused and made sick by stimulating food and drinks, and
repelling everything else, still gratefully opens itself to water. Wher-
ever man exists, therefore, or wherever he should exist, water is
found, either in the form of springs, or rnnning brooks, or rivers, or
ponds, or lakes ; and even where it is not found in some of these
forms, it is periodically dropped down from the clouds. As there is
no element in nature more necessary for man’s existence than water,
so there is none more universally diffused.
Pure Water Essential to Health. — But water varies very mate-
rially, both in its physical qualities, and in its adaptation to its pur-
poses. Pure water is as essential to health as pure air. When either
of these fluids is rendered impure by mixture with foreign matters,
disease will be a frequent result. The ancients must have been in-
fluenced by this fact, or they would not have incurred such heavy
expenses in procuring pure water from great distances. The strong
aqueducts through which, for many miles, large streams of water are
even at this day poured into Rome, attest the freeness of the expendi-
tures she made for this purpose in the day of her greatest renown.
We may pity the ancient Romans for being governed in their military
operations by tbe opinions of augurs and soothsayers, and certainly
these things were silly enough ; but in other things, at first view
equally superstitious, they showed practical wisdom. Vetruvius re-
ports that in selecting the sites of their cities, they inspected the
livers and spleens of animals to learn the salubrity of the waters and
the alimentary productions of the region. The size and condition of
these organs do in fact indicate the nature of the pasturage and the
qualities of the water with which animals are supplied. No people
can enjoy good health when subjected to the double influence of bad
water and impure air.
Division of Water. — The simplest division of water is into two
kinds, soft and hard. Rain, river, pond, and snow water is soft:
well and spring water is generally hard. Soft water contains but
little impurities, and when used for washing, forms a good lather
with soap. Hard water contains at least one of the salts of lime,
often more ; mixed with soap, it curdles and turns white. The reason
of this is, that the oily acids of the soap unite with the lime, and
form a compound which the water will not dissolve. Such water is
not suitable for domestic purposes.
Chemical Nature of Water. — Water contains, reckoning the ele-
ments of which it is composed in volumes, two volumes of hydrogen,
and one volume of oxygen. These two gases, the unlearned reader
HYG1EN15.
95
will please remember, are highly subtle bodies, not visible to the eye ;
and yet, when chemically united, they form a liquid which covers
two-thirds the entire surface of the globe, — floating upon its bosom
the navies and merchant ships of all nations, and by ite unmeasured
depths and vast breadths and sublime movements, fills the thoughtful
mind with conceptions of creative Power, which words never attempt
to express. Should the two gases which compose this vast body of
water cease to love each other, and fall asunder, the first lighted taper
would set the world on fire, and not a living being upon its surface
could escape destruction.
Impurities in Water. — It is not surprising that a fluid with as
great a solvent power as water, should often dissolve and hold in
solution a great many impurities. In passing along through the
earth, before it comes up in springs and wells, it is filtered through
various mineral earths, and becomes contaminated accordingly. In
running through beds of limestone, it takes up a little carbonate of
lime. Salt-beds impart to it common salt (muriate of soda), while
sulphur and other ores tinge it with salts of various kinds.
Water=SuppIy. — At the present time all large cities and most of
the towns in this country are supplied with water for domestic pur-
poses, either from ponds or lakes, or from artesian wells, of greater
or less purity, but in almost all cases superior to the common welh
water, so liable to contamination by cesspools and sewage. The re-
sult is that the health of the people has been materially improved,
and fevers, particularly those of a typhoid type, have diminished both
in prevalence and fatality. The decaying vegetable and animal mat-
ter, which formerly was washed into the soil, and percolated into and
poisoned the wells, is now washed away by copious supplies of pure,
fresh water.
Lead Pipes. — In cities, water is usually conveyed through the
dwellings in leaden pipes, — a practice fraught with a danger, to
avoid which various expedients have been devised. That lead does
often become oxidized and impart its poisonous properties to water
when long in contact with it, is a well-known fact. Let a number of
persons drink every morning from the the first water drawn from the
pipes, and a portion of them will be attacked with some form of lead
disease. The pipes should be emptied every morning before using
the water for domestic purposes, and then there is little danger. Tin-
lined pipes have been found to be almost entirely free from danger
of lead-poisoning.
Physical and Other Properties of Water. — Good water is with-
out smell, is perfectly clear, and in the mouth has a soft and lively
feel. When poured from one vessel to another, it should give out
air-bubbles. Boiled and distilled waters have a vapid, flat taste.
This is owing to their containing no carbonic acid gas or atmospheric
96 HYGIENE.
air, — these being driven off in the act of boiling and distilling. A
hundred cubic inches of good river water contain about 2^ of carbonic
acid, and of common air.
Carbonic acid is what gives to mineral, or soda water, its brisk,
and even pungent taste. Without a portion of tliis acid and atmos-
pheric air, water is perfectly insipid, and not fit to be used as a bev-
erage. Hence, if it be boiled or distilled to clear it of earthy matters,
we must expose a large surface of it to the air, and shake it, that 'it
may re-absorb from the atmosphere what it has lost, and thus recover
its taste.
Rain Water is the Result of Distillation on a large scale, and
would be insipid, like other distilled water, only that, after being
distilled off from the waters upon the surface of the earth, it recovers,
while ascending as vapor, the carbonic acid and atmospheric air.
Fishes breathe air as well as land-animals, and hence, lakes upon
the tops of high mountains, where but little oxygen can be absorbed
into the water from the air, are not inhabited by the finny tribes.
The Saltness of the Ocean is simply the accumulation of the saline
substances washed out of the bowels of the earth.
The water which for thousands of years has been distilling off as
vapor from the surface of the ocean is nearly pure. Being carried
by the winds to tlie continents, it falls as rain, sinks into the earth,
is filtered through mineral substances, comes to the surfaces in springs,
is collected into rivers, and, with all its freight of mineral salts, is
borne back to the ocean. Everything that water can dissolve, and
carry down from the continents, finds a great depository in the ocean ;
and as this has no outlet, the accumulation must go on without limit.
Rivers which flow into the ocean contain from ten to fifty grains of
salts to the gallon, — composed chiefly of common salt, sulphate and
carbonate of lime, magnesia, soda, potash and iron ; and these are
the constituents of sea-water.
Cleansing of Impure Water. — Impure waters should be cleansed
before being used for domestic purposes. Distillation is tbe most
perfect method of purification. Filtration through sand is a good
method. It removes all suspended vegetable or animal matter, and
all living animals. Boiling likewise kills all animals, and throws to
the bottom carbonate of lime. It is this which constitutes the crust
which lines tea-kettles in all regions where limestone exists.
Settlers in a new country should make it a prime object to find
good water. This is of great moment. Their own health and the
health of their posterity is dependent upon it. Any soil, good or
bad, is not worth half price, if it yield impure water.
Reasons for Prizing Water. — Finally, we ought all to prize water
very highly, for it composes nearly eight-tenths of our entire bodies^ in-
cluding our flesh, blood, and other fluids. Nay, we owe to it the very
HYGIENE.
97
softness, delicacy, and smoothness of our persons. Our muscles,
nerves, blood-vessels, glands, cartilages, etc., all play smoothly upon
each other in consequence of water. Take all the water out of us,
and we should be dry sticks indeed. All our comeliness would be
gone. Nobody would or could love us. We should be walking
reeds, shaken and sported with by every wind. Let us never forget
how much we are indebted to water.
Exercise.
Animal life is conditioned upon exercise. Without it health can-
not exist, or life itself be continued for any great length of time.
Proper exercise communicates motion to every part susceptible of
it. It expands the chest, contracts and relaxes the muscles, quickens
the motion of the blood, moves afresh all the other fluids, and stirs to
the centre of the whole frame. More easy and perfect digestion, the
nutrition of every part, and the proper performance of all the secre-
tions and excretions, are the results of such exercise.
A distinguished physician said : “ I know not which is most neces-
sary to the support of the human frame, food or motion.” Some of
the finest talents in the world are probably lost for the want of
exercise ; for without it the mind loses its keen perception and its
bounding energy, its power of application and its general scope. If
men of great talents would give attention to exercise, the world
would reap a larger harvest from their written thoughts.
The arrangements of modern society have very much abridged the
facilities for taking exercise ; but if Trenck in his damp prison,
with fetters of seventy pounds weight upon him, could preserve his
health by leaping about like a lion, most persons could do as much
with the fetters of modern society upon their limbs.
Must be Regular. — Exercise, to be of much service, must be regu-
lar, — not taken by fits and starts, — a good deal to-day and none to-
morrow ; but in reasonable measure every day. Occasional efforts,
with intervening inactivity, only does mischief.
Must be Pleasurable It should be connected, too, if possible,
with some pleasing occupation or pursuit. The movement of the
limbs should carry us towards some place or end in which the mind
feels an interest ; exercise will then do us most good. Hence botan-
ical pursuits, the cultivation of a garden, and the like, are often pre-
ferable to a solitary and aimless walk.
Must not be Excessive. — Exereise should never be carried so far
as to produce great fatigue. Extremes are injurious ; and too much
exercise, especially by a sick or feeble person, may be as injurious as
too little.
No clothing should be thrown off after exercise, nor should one
cool oft’ by sitting in a draft of air. Very serious consequences often
follow this practice.
HYGIENE.
9?
Not to be Taken After Meals. — It is not best to take exercise im-
mediately after meals. The reasons for this caution have been ex-
plained. It is true many laboring men go at once to their work after
eating, without apparent injury. Yet they are strong, and can en-
dure what those who use their brains chiefly could not. And even
they do not labor as easily and cheerfully immediately after dinner.
Active and Passive. — Exercise is properly divided into active and
passive. Walking, running, leaping, dancing, gardening, various
sports, etc., are active. While sailing, swinging, and riding in car-
riages are passive. Riding on horse-back is of a mixed nature, —
being both active and passive.
A few remarks upon these several kinds of exercise will have a
practical value to some of the readers of these pages.
Walking is one of the most gentle, easy, and generally one of the
most useful of the active exercises. It is within the reach of all who
have the use of their limbs, and is indulged at the expense only of a
little shoe-leather. To make it agreeable, the face is only to be
turned to some favorite locality, and the mind put in communion
with the voices of nature.
To walk with the best advantage, the body should be kept upright,
the shoulders thrown back, the breast projected a little forward, so as
to give the lungs full play, and the air an opportunity to descend to
the bottom of them. This attitude places all the organs of the body
in the most natural position, and relieves them from all restraint.
Walking then becomes a source of pleasure. The artist who bends
over his pallet, and gets into a cramped position, is by this kind of
walking relieved, and his body kept upright. Females, particularly
of the wealthier class, are much more apt to neglect this species of
exercise than males.
It is not so in England. There it is no uncommon thing for ladies
of high rank to walk ten miles a day ; and they do it in shoes of suf-
ficient thickness to protect their feet from all dampness, and in
clothes large enough to give their muscles full play. As a conse-
quence, they enjoy excellent health, and in many cases even retain
their freshness and beauty to old age.
A master of one of the vessels of our navy who spent some time,
lately, in the British Channel, was several times invited to spend the
evening at Lord Hardwick’s, where he made the acquaintance of two
daughters of his lordship, who, in the drawing-room, he thought the
most accomplished ladies he ever saw. Yet those young women, on
two occasions, in company with other friends, walked miles to visit
his vessel, once on a rainy day, clad in thick, coarse cloth cloaks which
no rain could penetrate, and caring as little for wet weather as a
couple of duckso
Good for the Studious. — For the studious, walking is a most capi-
tal exercise. It varies the scenes so constantly, and brings the mind
HYGIENE.
99
m contact with so many objects, that the monotony of in-door life is
admirably broken. It was a maxim of Plato, that “ he is truly a crip-
ple, who, cultivating his mind alone, suffers his body to languish.”
Good in Cold Weather. — Walking is valuable in cold weather,
because it exposes one to the cold atmosphere, and hardens the person
against frosty weather, — a consideration of great consequence in
countries which are subject to extremes of cold.
Running and Leaping are forms of exercise which should be in-
dulged with prudence even by the young and healthy. For the feeble
and the aged, they are entirely inadmissible. Used cautiously, in a
system of regular training, they may help raise the bodily powers to
a high degree of agility and endurance. The North American Indian,
who was bred to the chase, ran with surprising swiftness, and for en-
durance was scarcely excelled by his faithful dog. What training
has done for the Indian, it may do for the white man, who may
chance to inherit as good a constitution.
The Game of Base°BalI requires very active running, and for the
young, it is an exceedingly healthful amusement. It fills the whole
frame with a bounding spirit, and sets the currents of life running
like swollen brooks after heavy rains.
Gymnastics. — The more active species of exercise have generally
been included under the term gymnastics. Among the Greeks and
Romans, feats of strength and endurance were supposed to confer
honor. For this reason, and because war was a laborious calling, re-
quiring bodily endurance and strength, their youth were trained in
the most active exercises. Gymnastic games were with them at once
the school of health and the military academy.
In England, during the middle ages, acts of Parliament and royal
proclamations were employed to regulate and foster those manly
sports and exercises, which fitted the people for the activity required
on the field of battle.
Those preparations for brutal wars would be unsuited to the pres
ent state of the world ; but the capacity for endurance which these
trainings produced, could be most usefully employed in the laborious
and scientific researches which modern advancement requires. Very
lew of our scientific men have sufficient hardness of frame to sustain
them in their laborious studies.
The heart-diseases which prevail so extensively are the result,
many of them, of violent exercise, taken, perhaps, from necessity, and
proving injurious because not a matter of every-day practice. Violent
exercise, more than any other kind, must be regular in order to be
borne.
Needed by Young Women. — Gymnastic exercises and calisthenics
are particularly needed by our young women, to give them something
of the robustness of our mothers, a few generations back. For the
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HYGIENE.
want of them, they are dwindling away, and becoming almost worth-
less for all the purposes for which they were made.
In view of this want of exercise the introduction of the bicycle
offers an excellent means of development for ladies, and it is very
gratifying to note its increasing use. It brings into play many of
the muscles of the body, while affording an exhilarating enjoyment
of fresh air and changing scenery. But caution must be used, not to
overdo one’s self. Short rides only should be taken at first, increas-
ing the distance as the muscles become hardened.
Moderns Physically Inferior to the Ancients. Reason for it. —
It is evident that the moderns are inferior in bodily strength to the
ancient Greeks and Romans. Before the introduction of Christianity,
men knew very little about the future, and therefore strove to make
the most of the present. Hence, they took measures to ensure health
and long life. It is true that a due regard to the welfare of the fu-
ture need not, and should not, prevent a care for the present ; but
from various causes, to be referred to on a subsequent page, such has
been the practice, to the manifest physical injury of the race.
Dancing, when hedged about with proper restrictions and limita-
tions, has great advantages as a physical training for the young.
There are very few forms of exercise wliich give so free a play to all
the muscles, and at the same time so agreeably interest the mind.
Begun in early life, and pursued systematically, dancing imparts a
grace and ease of motion which nothing else can give. For this rea-
son alone, it should be cultivated as an art.
Every man and woman is often placed in circumstances in life
where the possession of an easy carriage of body, and an unembar-
rassed manner, would be prized above gold. One’s personal influence
in tlie world is greatly increased by an easy, graceful manner. We
all know how a polite manner wins, while a rough and uncouth one
repels us.
Warning against Excess. — While dancing has many things to
recommend it, there are also several considerations which should warn
us against using it to excess, particularly in the ball-rooms of fashion-
able life. So many muscles are called into play, the breathing is so
much quickened, and the air breathed is often so impure, that the
circulation of the blood is hastened almost to fever excitement. And
when to this we add the use of wines and cordials, alternated with
ices and iced drinks, and the exposure, on returning home from balls,
to the chilly night air, under the insufficient protection of light cloth-
ing, we have drawbacks enough to abridge, if not to annihilate the
benefits derived from this otherwise healthful and elegant exercise.
But then it will be said, and truly enough, that these are the abuses,
not the uses of dancing. To these abuses, no parent should permit
the health of a child to be exposed. In the parlor at home, with a few
young friends gathered in to spend an evening ; or, in a well-venti-
HYGieNf;.
iol
lated hall, under the instruction of a master of known character and
refinement, dancing is of high utility, and much may be said in its
favor. An amusement for which there is so general a fondness, one
may say, passion, must be fitted to meet some want of the animal
economy, and perhaps of man’s higher nature.
Grace of motion gratifies our sense of the beautiful, and in its na>
ture is allied to poetry. Turning away from the abuses of dancing,
let the reacder thankfully use it as one of the very best physical, so-
cial, and aesthetical educators of youth.
But if dancing is salutary, it is only when every limb and muscle
is allowed to participate naturally and without restraint in the general
motion. When performed in a dress so tight as to restrain all free-
dom, not only is every grace destroyed, but injury of a serious char-
acter may be the result.
The Cultivation of a Garden is also a species of exercise highly
conducive to health. To the poor it should have a double attraction.
It is not only a healthful exercise, but it yields, in its season, many
wholesome vegetables, the price of which, when they have to be pur-
chased, frequently puts them beyond their reach. It is pleasant to
know that in many of our manufacturing towns the workmen own
small pieces of ground which they cultivate as gardens, — deriving
health both from the labor, and from the vegetables raised. This is
one of the kinds of exercise which are more beneficial from having
an end in view. The man who works in his garden derives pleasure
from the improvement he is making upon his ground, and from the
prospect of advantage to himself and family.
' Other Active Exercises. — To the exercises already spoken of may
be added those which are mostly taken indoors, — the dumb-bells,
jumping the rope, battledore, etc. They may be resorted to when
the weather is stormy, or when any other cause may prevent one
from going into the open air. Nevertheless, as promoters of health,
they are inferior to those exercises which take one out under the
open sky. They are too mechanical in their nature, and have too
little aim, to be allowed to take the place of the preceding.
Passive Exercises.
Sailing. — This, to many persons, is among the most pleasurable
and exciting of the passive exercises. But the excitement arising
from the motions of a boat, sometimes, in case of timid persons, de-
generates into /ear, which is injurious. Young gentlemen who man-
age the boat upon sailing excursions, should never put on too much
sail in a brisk wind, and torment the ladies by exciting their fears, as
their own amusement may be in this way purchased at the cost of
others’ health, — a result far enough from their thoughts or inteur
tions, but not the less real.
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HYGIENE.
Swinging. — The sick may sometimes indulg e in this exercise, when
capable of enduring no other.- To swing gently has a soothing effect,
and often allays nervous irritability in a way which nothing else can.
It is like the lullaby motion of the cradle. It calms and soothes.
Nervous children and grown persons in feeble health are some
times, by roguish boys, swung too high, and very much excited and
alarmed. This is wrong. It may do great injury. Very few boys
would do it if they knew the evil consequences. Boys and girls are
generally kind-hearted ; and though they may like to hector others,
they will seldom knowingly injure them for their own amusement.
Carriage-Riding, — The advantages to be derived from this species
of exercise are probably rated too high. For feeble persons, just re-
covering from illness, who cannot endure walking or riding on horse
back, it is valuable, particularly if taken in an open carriage. But for
those who have more strength, it is less desirable than many other
exercises. True, it is generally an agreeable mode of locomotion, and
for this reason, it is more serviceable than the small amount of exer-
cise afforded by it would lead one to suppose.
Carriages are luxuries, and like all other luxuries, they are apt to
bring on debility, and perhaps shorten life. A man is apt to order
his carriage to the door at the time wdien increasing wealth enables
him to retire from the active pursuits of life,— the very moment when
he is most in need of some exertion to take the place of that to which
he has been accustomed. Yet so it is, luxury comes to enfeeble, at
the time when we need something to harden us.
Could rich men be persuaded to let their luxuries consist, in part,
in doing good, and, like Howard, find pleasure in travelling on foot
to visit those who are sick and in prison, they would be surprised to
see how their happiness would be increased.
Close carriages are generally used by the wealthy. They at best
contain but little air, which is breathed over and over, and becomes
unfit for respiration. The windows of such carriages should always
be open, except in rainy weather, when the latticed windows only
should be used.
Riding in Sleighs furnishes an agreeable excitement, and may be
indulged in to some extent with advantage. Yet it can be had only
in cold weather, and persons who partake of its pleasures should be
careful to wear clothing enough to protect themselves against the
frost. This is the more necessary, as very little motion is communi-
cated to their bodies by the sleigh.
Horseback Riding. — This form of exercise may fairly rank next
to walking ; in some states of the system it is preferable. It justly
holds a high rank as an exercise for consumptive persons. Many a
man, and woman too, has been benefited by it when suffering from
lung disease. For those who have hernia, or falling of the bowel, it
is not proper, as the most serious consequences may result from its
use.
HYGIENE.
103
The Horse should be Owned, — A feeble man who rides on horse-
back, should, if possible, own his horse ; for, becoming attached to
him, as he generally does, he will be able to ride farther than upon
an animal in which he feels less interest. A horse is a noble crea-
ture, and a man who loves him will sometimes acquire a passion,
almost, for beingupon his back, and witnessing his splendid perform-
ances.
Pleasurable Exercises most Beneficial. — Finally, those exercises
are most beneficial, and can be longest endured, in which we feel the
greatest interest. Place before even a feeble man some desirable ob-
ject, and he will endure a great deal to reach it; or engage the mind
of a very tired person in something which greatly interests it, and
considerably more exertion will be easily borne. This is well illus-
trated by the story told by Miss Edgeworth of a certain father, who
had taken a long walk with his little son, and found the boy appar-
ently unable to walk further, some time before reaching home.
“ Here,” said the shrewd-minded father, “ ride on my gold-headed
cane.” Immediately the little fellow was astride the cane, which
carried him as safely home as the freshest horse.
Mental Co-operation is of the highest importance in all exercise.
Men who are paid by the job, work with far more spirit than those
who are paid by the day. One would dig in the earth with very
little spirit, if he had no motive for doing it ; but if expected with
every shovelful of earth to bring up gold-dust, he would not only
work with a will, but would endure a great deal more labor. From
these considerations we may infer that those farmers and manufac-
turers who pay their men the highest wages, make the most money
on their work.
The best time for taking exercise is that in which it does us most
good. For most persons the morning hours may be considered most
favorable. But there are many who cannot take exercise in the early
morning, without suffering from it through the Avhole day. Some
are able to walk; miles in the afternoon, who would be made sick by
similar exertions immediately after rising.
Persons often injure friends who have this peculiarity of constitu-
tion by urging them out in the morning. They do it from good mo-
tives, but are, nevertheless, blameworthy for attempting to advise in
matters which they do not understand.
Rest and Sleep.
Ottr bodies are like clocks ; they run down and are wound up once
every twenty-four hours. Were they obliged to work on uninter-
ruptedly, they would wear out in a few days. It is a merciful pro-
vision that periods of repose are allotted to us. Evervthing has its
104
HYGIENE.
proper place. Rest is not less a luxury after exercise, than exercise
is aher rest. They both confer happiness at the same time that they
promote our well-being.
Sleeping Rooms, — 'J'he largest part of our rest is taken in sleep.
Of course the kind of room in which we sleep is worthy of considera-
tion. Huf eland says: “It must not be forgotten that we spend a
considerable portion of our lives in the bed-chamber, and consequently
that its healthiness or unhealthiness cannot fail to have a very im-
portant influence upon our physical well-being.” It should at least
be large. That is of prime importance, because, during the several
hours that we are in bed, we need to breathe a great deal of air, and
our health is injured when we are obliged to breathe it several times
over. We should at least pay as much attention to the size, situa-
tion, temperature, and cleanliness of the room we occupy during the
hours of repose, as to the parlors, or drawing-room, or any other
apartment. And yet how different from this is the general practice
of families. The smallest room in the house is commonly set apart
for the bed and its nightlj^ occupants.
The sleeping-room should have a good location, so as to be dry.
It should be kept clean, and neither be too hot nor too cold. And,
more important still, it should be well ventilated.
One bed, occupied by two persons, is as much as should ever be
allowed in a single room; though, of course, two beds in a large room
are no more than one in a small one. Both are objectionable.
Fire in Sleeping Rooms. — As to having fire in a sleeping room,
that is a matter to be determined by the health of the occupant.
Persons who have poor circulation, and are feeble, had better have a
little fire in the bed-chamber in cold weather. For those in good
health a cold room is preferable.
Open Windows in Sleeping Rooms. — In the hot weather of sum-
mer, it is better to keep the windows open to some extent, through
the night, but not on opposite sides of the room so as to make a draft
across the bed.
There is a difference of opinion as to the safety of this practice,
but the experience of those who have used it prudently and persever-
ingly has generally sanctioned its employment. It is presumed that
night-air is made to be breathed; and if we breathe it habitually,
there is no good reason why it should be considered hurtful. At all
events we have got to do one of three things, — either breathe it, or
be poisoned by air which is breathed several times over, or use very
large sleeping rooms, and then lay in a stock to last over night.
An Open Fireplace in a bed-chamber will do much towards its
purification. It carries off foul air. But many persons board up this
outlet as if bad air were a friend with whom they could not think of
parting. At the same time they will carefully close all windows and
doors, as if fresh air were an enemy not to be let in.
HYGIENE.
105
Beds. It is a pleasant thought that while so many things whicl)
injure health are coming into fashion, some which have a like effect
are going out. Among the injurious things which are silently with-
drawing are feather-beds.
In earlier times, a bed made of eider-down was thought to be a
great luxury, to be carefully preserved, and handed down from mother
to daughter. Beds made of hen’s feathers, and other coarser kinds,
were thought to be only fit for children. With due deference to
these earlier judgments, it must be said that feather beds, whether
downy or coarse, are not even fit for children. They are composed
of animal matter, and by a slow process of decay, are always, when
stirred, sending up an exhalation which it is not healthful to breathe. '
By their softness, too, they increase the general tendency to effemi-
nacy. In warm weather they are too heating. To sink down into
them, and lie nearly buried all night, is to insure a feeling of lassi-
tude and debility in the morning. Only the strongest persons can
endure it without being made conscious of the evil effects.
Beds must not be too Hard. — On the other hand, it is almost
equally unwise to choose a bed of absolutely unyielding hardness.
When very tired, we may rest even upon a board ; but sleep will
generally be more sound as well as refreshing, if the bed be some-
what }delding. The hair mattress is the very best bed yet used. It
is healthful and easy. No person once accustomed to it will ever
return to feathers In summer, it is a luxury ; in winter, it is suffi-
ciently warm, though a little more covering is needed than with
feathers.
Bedding. — In hot weather, linen sheets are preferable to cotton,
and of course will be used by those who have ample means. But
cotton ones are good enough, and in winter are decidedly the more
desirable of the two. Cotton is best, too, for those who suffer with
rheumatic affections. For external covering, comforts are objection-
able, because they do not let the insensible perspiration pass off as
freely as it should. They are light, however, and so are rose blankets,
which have the additional good quality of being porous. We should
sleep under as few clothes as possible, consistently with comfort.
Night-Dress. — The flannel, cotton, linen, or silk, worn next the
skin through the day, should always be replaced, on retiring, by a
suitable night-dress. The undershirt should be of the same ma-
terial with that which is taken off, but thinner. If we wear flannel
through the day, we need it quite as much at night.
Do not Cover the Face. — The practice of sleeping with the face
entirely covered with the bed-clothes is very injurious. It compels
one to breathe the air over several times.
Natural Position for Sleep. — The most natural position in which
to sleep is upon the right side. This affords the easiest play to the
106
HYGIENE.
internal organs. It is best, however, to learn to sleep in different
positions, and to change occasionally from side to side. Upon the
back is not so easy a position. To lie in this way obstructs the cir-
culation of the blood, by the pressure of the stomach, bowels, etc.,
upon the large blood-vessels which pass down and up in front of the
backbone. It is very tiresome and injurious to lie ivith the hands
above the head.
Amount of Sleep. — The average amount of sleep required by
persons in health is from seven to eight hours. Occasionally we find
persons who get along very well with six, or even five hours ; while
some, even in health, require nine. There is no absolute standard
for all persons, in the amount of sleep, any more than in that of
food. It depends on the temperament, the constitution, the amount
of exercise, and the exhausting nature of the mental application.
The object of sleep is to repair the energies, the extent to which
they are wasted, and the recuperative power possessed, will measure
the amount required.
Late Suppers. — These are a bar to all sound and healthful sleep.
The last meal should always be taken at least three hours before re-
tiring and should be light. During sleep the stomach should have a
chance to rest. It will work the better on the morrow. Some per-
sons boast that they can sleep perfectly well after a heavy supper.
Perhaps they can, but, as Franklin has wisely suggested, they may
by and by “ have a fit of apoplexy, and sleep till doomsday.” This
will be sleeping too well!
Preparation for Sleep. — Dr. Franklin left behind the record ol
a wise life, as well as many excellent moral and philosophical direc-
tions. A good conscience was his prescription for quiet sleep and
pleasant dreams, — a most excellent direction. Sleep is promoted,
too, by withdrawing the mind, a short time before retiring, from all
hard study and exciting themes of conversation, and turning it to
calmer subjects of reflection, such as the moral attributes of God, and
particularly his love and paternal character
Objects of Clothing.
The clothes we wear are intended, or should be intended, to secure
three objects, — warmth in winter., coolness in summer., and health at all
times.
It has already been shown that our bodies are warmed by their
own internal fires. In the lungs, in the skin, and indeed in all parts
of the body, oxygen unites with carbon and other combustible mat-
ters, producing heat in the same way that it is produced in a grate
where coal is burned ; and as our temperature always needs to be kept
to about 98° Farenheit, it follows that this combustion must always
be going on.
HYGIENE.
107
Now, the atmosphere which surrounds us is always receiving into
itself the heat which comes to the surface of our bodies, and thus
robbing us of our warmth. In summer, the atmosphere, full of the
rays of a burning sun, may impart heat, instead of taking it away ;
wliile in winter it takes more than it gives, and would cause us to
perish with the cold, were it not for the protection afforded by our
clothing.
Clothes, of course, have no power to manufacture or impart heat.
They only retain, and keep in contact with our bodies, that which is
generated within us. If we have on a single garment which is made
tight at the bottom and top, so that no current can pass up or down,
there will be a layer of air between it and the body, which, becoming
immediately heated, and being retained there, helps keep us warm, or
rather, prevents us from being cold. With every additional garment
put over this, there is another layer of heated air, adding still more
impenetrable guards against either the intrusion of cold, or the escape
of internal heat.
Bad Conductors of Heat. — But, that our clothes may thus retain
our warmth, and prevent its dispersion, they must be bad conductors
of heat, — that is, they must not readily take up the heat and convey
it away from the body. They must slowly absorb the caloric into
their own substance, and then retain it tenaciously.
Linen, which is so universally popular in temperate climates, as
an article to be worn next the skin, is unfortunately a good conduc-
tor of heat. It does not afford a warm garment. It conducts heat
rapidly away from the body. Hence it always
feels cool to the touch. It is really no colder in
itself than other kinds of cloth, but it is solely
the rapidity with which it conducts heat away
from the body, that gives it the feeling of cold-
ness. It has other qualities which compensate,
in some measure, for this defect. The fibres of which it is composed
are round and pliable, which makes linen cloth smooth and soft, and
the sensations produced by it on the skin altogether agreeable. Fig.
67 represents a fibre of linen, as it appears under a microscope which
magnifies it 165 times.
Cotton is warmer than linen, because it is a worse conductor of
heat. The perfection to which its manufacture has been carried,
makes it almost a rival of linen in softness and pliability. It does
not absorb as much moisture as linen, and there
fore better retains its powers as a non-conductor.
But then the fibres of cotton are not round and
smooth, like those of linen, but flat and spiral,
with sharp edges. Fig. 68 represents two of its
fibres, magnified 155 times. This renders cotton
irritable to some very delicate skins. This is the reason why linen
Fig. 68.
Fig. 67.
• 108
HYGIENE.
is better than cotton for binding up wounds, where there is tender-
ness of the surface.
Silk has a round fibre, like linen, which is even softer and smaller.
It absorbs less moisture than cotton, and in its power of retaining
warmth, it is superior to both the preceding. It forms the most de-
sirable fabric for clothing that we have ; but its cost makes it inacces-
sible to the great body of the people, except as a holiday dress for
the ladies. Its culture in our country, if extensively established,
would be a source of national wealth.
The Fibre of Wool is quite rough, almost scaly, and highly irrita-
tive to delicate skins. Fig. 69 shows fibres magnified 310 times. It
is not possible for some persons to wear it next
the skin. But where this cannot be done it may
be worn outside the linen or cotton ; and being a
good non-conductor, it will in this way preserve
the warmth of the body, without either irritating
the skin, or disturbing its electricity.
Wool, in cold climates, is one of the very best
materials of which clothes can be made. In New
England, and, indeed, in all cold and temperate
regions, it should be worn by delicate persons, in
the form of thick or thin garments, all the year round. It does not
readily absorb moisture, and is a dry, warm, and wholesome material
for clothing.
Hair. — Though not precisely in the line of these remarks, hair
may as well be introduced here. Wool is in fact hair. Every part
of the skin, with the exception of that upon the soles of the feet, and
the palms of the hands, is intended to produce hairs. On most parts
of the body, they are short and fine, hardly rising above the surface.
Upon the head and the face, they grow to considerable length.
Hair, like wool, is a bad conductor of heat ; and, as growing upon
the head and face, is doubtless intended for some useful purpose.
That it was designed as a warm covering, can hardly be doubted.
The beard, when permitted to grow, is a natural respirator, guarding
the lungs against cold and dust. It has been noticed that black-
smiths who have allowed their beards to grow, had their mustache
discolored by iron-dust, which lodged among the hairs, and very
justly inferred that the dust must have found its way into the lungs,
and done mischief, had it not been arrested by this natural respirator.
That the beard, when long, does ward off a great many colds and
throat troubles, is too well known to be denied. It has required moral
courage on the part of those who have broken away
from the universal practice of shaving, for which they
should be honored rather than ridiculed. For those
who do not suffer from throat or lung complaints, espe-
cially if they are getting advanced in life, it may not be
thought worth while to abandon the razor. Yet the change would
Fig, 70.
HYGIENE.
109
not be regretted. Fig. 70 is a human hair, magnified 250 times,
showing ite scaly surface.
The Color of our Clothing is a matter of some moment. The dark
colors absorb the light, the sun’s rays, and heat, much more than the
lighter ones ; and as those bodies which absorb heat well are likewise
good radiators, the dark colors have the highest radiating power. White
reflects heat and rays of light, and is a bad absorber and bad radiator.
In summer it prevents the sun’s rays from passing inward to heat the
body, and in winter, interrupts the heat of the body in its passage
out. In summer, it makes the coolest garment ; in winter the warmest
one. These facts can be very simply illustrated, by laying, side by
side, upon the snow, when the sun shines, two pieces of cloth, the
one black, the other white. Lifting them up, after a time, the snow
will be found considerably melted under the black cloth, hut not under
the white.
It is now seen that the object of clothing is not to impart heat to
the body, but to prevent its loss ; that it is not to create it, but to
furnish the occasion for increasing its degree. It appears further,
that clothing protects the body against the evil effects of changes of
temperature, and that white garments, hy reflecting, instead of ab-
sorbing heat, guard it against the heat of summer.
Clothing should be Porous. — All articles used for garments should
be porous, and permit the free passage of insensible perspiration. The
skin receives oxygen through its pores, and gives back carbonic acid.
It performs a sort of subordinate respiration. India-rubber garments,
worn next to it, interrupt this, and must do mischief. Shoes made
of this material soon cause the feet to become damp and cold. The
dampness is occasioned by the insensible perspiration, which cannot
escape through the rubber. Such shoes worn in the open air, should
be immediately taken off on entering the house.
Thin Shoes. — The defective way in whieh American females pro-
tect their feet from cold and wet, is a sore evil; and he who persuades
them to adopt a wiser fashion, and cover their feet with better guards
against colds and consumption, will deserve the gratitude of the na-
tion. We are in many things too fond of copying foreign fashions;
but if our ladies would, in this matter, follow the excellent example
of English women, they would live longer, and leave a hardier pos-
terity behind them.
The shoes worn by our females, high and low, rich and poor, are
not thick enough to walk with safety upon a painted floor, hardly
upon a carpet in an un warmed room; and yet they walk with them
upon cold brick sidewalks, upon damp and frozen ground, and even
in mud.
The result is, that they suffer from colds, sore throats, pleurisies,
lung-fevers, suppressions, inflammations of the womb, and many other
ailments, which in early life rob them of their freshness and beauty.
no
HYGIENE.
of their health and comfort, of their usefulness to their household
and the world, and leave them helpless in the arms of their friends,
with a patrimony of suffering for themselves while they live and a
legacy of disease to hand down to their children. Would that they
were wise in season ! Some, to their honor be it said, have already
adopted a safer course. It is hoped the evil will be gradually cor-
rected.
Never attempt to mould the Form by Dress. — Parents commit a
great error when they attempt to mould the forms of their children,
particularly their daughters, by their dress. This cannot be done.
It IS the worlv of nature, and she Avants no assistance in it. T'he
great object of dress in childhood, as well as in adult life, is to pro-
mote health. With this, there is not much difficulty in preserving
the symmetry ; without it, deformity is almost a matter of course.
The fact cannot be too often repeated, nor too seriously urged upon
parents, that wliile the foundation of ail graceful and just proportion
of the different parts of the body must be laid in infancy, it cannot
be done by tight bands, and ligatures upon the chest, and loins, and
legs, and arms. Upon all these points, the garments of children
should set easy, leaving the muscles at liberty to assume the fine
swell and development which nothing short of unconstrained exercise
can give. Could infants tell all the horrors they suffer from the re-
straints put upon them by tight dresses, it would make many a
mother’s heart bleed.
In these brief remarks, the principles are given which should guide
us in the selection of our clothing. The intelligent reader will be
able very easily to fill up the outline.
Bathing and Cleanliness.
Aristotle calls cleanliness one of the half virtues ; and Addison,
in the Spectator, recommends it as a mark of politeness, and as analo-
gous to purity of mind. Both in the Jewish and Mohammedan law,
it is enforced as a part of religious duty. Its requirement as a pre-
requisite to Christian communion would be wiser than the demands
sometimes made. A dirty Christian may perhaps be found, but not
among those who mean to be intelligent.
The importance of keeping the skin clean is not generally appreci-
ated. The motive for cleanliness is often a lower and meaner one
than should be allowed to have place in the mind. Many persons
would be mortified to have their hands, or face, or neck dirty, who
do not wash their whole body once a year. That they may appear
well in the eyes of others, is the only motive with such for keeping
clea^i.
Offices of the Skin. — If we look a little at the offices of the skin,
we shall better understand the need of keeping it clean.
fiYGlENE.
Ill
The skin is not merely a covering to protect us from the weather.
It is a living structure, curiously wrought, with a large extent of sur-
face, and having important duties to perform in the animal economy.
Its structure is more particularly explained under the head of “ Anat-
omy ” and “ Skin Diseases.” It has been already said, that it helps
the lungs in breathing. It does many other things on which the health
is dependent.
Number of Perspiratory Tubes. — The skin performs several
kinds of secretion, — that is, it separates several things from the
blood, — one of which is the perspiration, or sweat. The sweat is
formed in small glands, situated just under the skin, and is brought
to the surface in small ducts, or tubes, like the hose thiough which
fii'emen throw water. These little tubes are spiral, as seen in cut 44,
and run up through the two skins.
These spiral canals are very numerous, covering every part of the
human frame, — there being about 2800 of them upon every square
inch throughout the body ; and as a man of ordinary size has about
2500 square inches of surface, the numbei' of tubes in the skin of one
man is seven millions.
The mouths of these tubes are called the pores of the skin. Each
one of these tubes is extended just below the skin ; and there, among
the cells where the fat is deposited it, or rather the two branches into
which it is divided, is wound into a coil, called the sudoriferous or
sweat gland. These ducts are each about a quarter of an inch in
length, which make an aggregate length of tubing in the human skin
of about twenty-eight miles.
Insensible Perspiration. — Through each of these seven million of
quarter-inch hose, there is poured out, day and night, as long as a
man lives, a stream of sweat in the form of vapor. When this is
thrown off very rapidly, as happens when active exercise is taken, it
accumulates in drops, and is called sweat. Ordinarily it does not
thus accumulate ; it is then called insensible perspiration, — not
being recognized by the senses.
This transpiration may be proved very beautifully by inserting the
naked arm into a long glass jar, and closing up the space around it
at the mouth so that no air can get in. The inside of the glass will
soon be covered with a vapor, which will grow more and more dense
until it is converted into drops. Boerhaave says : “ If the piercing
chill of winter could be introduced into a summer assembly, the in-
sensible perspiration being suddenly condensed, would give to each
person the appearance of a heathen deity, wrapped in his own sepa-
rate cloud.”
Now, this continual exudation of sweat through these millions of
tubes is for a wise and necessary purpose. It is to take out of the
blood and other fluids various salts, which would do mischief if
allowed to remain longer, and particularly carbonic acid, which is
112
HYGIENE.
poisonous, — the same matters, in fact, which are tlu-own out by the
lungs. The skin, in truth, is a kind of helper of the lungs ; and a
lady, by covering herself with garments which have no pores, and
will neither admit air nor let off insensible perspiration, may be
strangled almost as certainly as by putting a cord around her neck,
and closing her windpipe. Almost twice as much fluid passes off
through the skin as through the lungs.
Keep the Pores Open. — It is obvious from what has now been
said, that the pores of the skin should be kept open to preserve
health. When bathing is neglected, and the undergarments are not
changed sufficiently often, the insensible perspiration accumulates
and dries up upon the skin, mingling with the oily matter secreted
by the oil-glands, and with the slireds of the scarf-skin, and form-
ing a tenacious gluey matter, which closes up the pores. By this
misfortune, that large quantity of worn-out matter which usually
goes off with the fluid through the pores is retained to poison and
embarrass the living current of blood, or seek an outlet through lungs
or kidneys, which are already burdened with quite as much as they
are able to do. How important, then, that these channels through
which the body is purified should be kept open ! that the skin should
be kept healthy and in working order !
The Bath, the Great Purifier. — But this can only be done bj
daily washing. The bath is the great purifier of the human skin.
The antiquity of bathing is very great. The practice is supposed
to reach back to the infancy of the race, or certainly to a very early
period. The inhabitants of Middle Asia are said to have been the
first to use the bath for the specific purposes of purification and
health. Domestic baths are represented as having been used by
Diomed and Ulysses. Andromache prepared warm water for Hector
on his return from battle. Penelope banished sorrow by unguents
and baths.
The Baths of the Medes, the Persians, and the Assyrians were
much celebrated. Alexander, though familiar with the voluptuous
baths of Greece and Macedon, was astonished at the magnificence of
those of Darius.
Roman Baths. — As luxury and refinement advanced, the means
of luxurious bathing were multiplied, until establishments were
built by the Romans, the very remains of which excite wonder at
this day. Among these are the Thermae of Agrippa, of Nero, of
Vespasian, of Titus, etc. One of the halls of the building con-
structed for baths by Diocletian, forms at this day the church of the
Carthusians, one of the most magnificent temples in Rome.
Number and Character. — According to Pliny, baths were intro-
duced into Rome about the time of Pompey ; their first erection
Dion attributes to Maecenas. Agrippa increased their number to
HYGIENE.
113
one hundred and seventy ; and within two hundred years they were
multiplied to about eight hundred. These establishments were so
vast that one writer compares them to provinces. They were paved
either with crystal, or mosaic, or plaster, and were adorned by sculp-
ture and painting to the very highest degree. They added not
merely to the health and luxury of the people, but contributed to
their culture in the highest departments of art and taste.
Names of Baths. — To the apartment of their dwelling in which
they washed their bodies in warm or hot water, the Romans gave
the name of balneum, or bath ; to the public establishments, that of
balnea, or baths. The apartment which held the vessels was called
vasarium. In this were the three immense vessels which contained
the cold, warm, and hot water. There were instruments of bone,
ivory, and metal, for scraping the skin, with a groove in the edge,
through which the impurities of the skin might run off.
On the north front of the thermae was a reservoir of cold water
large enough for swimming, called by Pliny the younger, baptisterium.
In the centre was a spacious vestibiile, and on each side, warm, cold,
and vapor baths, with apartments for cooling, dressing, and refresh-
ments. There was the frigidarium, a vaulted room, a cooling room
midway between the warmer and the open air ; the tepidarium, with
a temperature midway between the above and the hot bath ; and the
calidarium, or the vapor bath.
Then there was the room where the body was rubbed over with a
great number of ointments and essences of the most precious kinds ;
and another in which it was sprinkled over with powder ; and also a
room which held the clothes, in which the bathers undressed and
dressed at pleasure.
All these apartments were double, the two wings being appropri-
ated to the sexes.
Open to all. — These baths, thus numerous and magnificent, were
open to all classes of the people, and contributed largely to the gen-
eral health and physical endurance for which the Romans were con-
spicuous.
The Bath Neglected under the Christian System. — When Jesus
of Nazareth came into the world, he found man’s nature cultivated
in a most defective way. The moral element had sunk down to tlie
lowest place, while the physical had risen to the highest, — just the
reverse of the true order of things. This Divine Teacher came, not
to recommend a neglect of the body, but a new cure for the imper-
ishable part. Mankind were for the first time systematically taught
to forgive injuries. Prostrate liberty and degraded woman became
the wards of Christianity.
Unfortunately, under the new order of things, the lower element
of man, which had been exalted and worshipped, was cast down and
abused. What the Pagan had pampered, the Christian persecuted.
114
HYGIENE.
The body, which had been bathed, and scrubbed, and anointed, and
perfumed, was thenceforward, in consequence of the improper inter-
pretation of certain texts, scourged, and fasted, and clothed in rags.
Thousands believed, and thousands do to this day, that to torment
the body is to please God. Under this feeling, the public and pri-
vate baths were neglected , and to this day no Chiistian nation has
fully appreciated the necessity of cleanliness, and of sanitary meas-
ures for the maintenance of the public health. To a considerable
extent, the body is still under disabilities ; still the subject of perse-
cution ; and where this is not the case, it is too often regarded only
as a loose outside garment, to be thrown over the traveller to the
celestial city, and is expected to be well soiled with mud and dust.
The teachings of the Great Master will by and by cease to be per-
verted, and will be applied to raise up man’s body, as they have
raised his mental and moral nature, and will make a well-developed
and harmonious being.
In the meantime, it is the duty and the privilege of the physician
to urge a return, not to the magnificence of the ancient regimen for
training the body, but to its real efficiency in a simpler form.
Cold Bathing. — Water applied to the skin at a temperature below
76° of Farenheit, is called a cold bath. If applied to a person with
sufficient constitutional energy to bear it, it is a decided and very
powerful tonic. By this is meant that it promotes the solidity, com-
pactness, and strength of the body.
The first effect of the application of cold water to the skin, is the
sudden contraction of all its vessels, and the retreat of the blood
towards the internal organs. The nervous system, feeling the shock,
causes the heart to contract with more energy, and throw the blood
back with new force to the surface.
This rushing of the blood back to the skin, is called a reaction ;
and when it occurs with some energy, it is an evidence that the sys-
tem is in a condition to be much benefited by the cold bath. When
this does not take place, but the skin looks shrunken, and covered
with “ goose flesh,” and a chilliness is felt for a longer or shorter time
after bathing, then the inference should he, either that the water has
been used too profusely, or that the bather has too little reactionary
power for this form of the bath. The latter conclusion must not be
accepted until cold water has been tried with all possible guards, —
such as beginning with tepid water, and gradually lowering the tem-
perature ; bathing for a time, at least, in a warm room ; beginning
the practice in warm weather ; and applying the water at first with a
sponge out of which most of it has been pressed by the hand. With
some or all of these precautions, most persons may learn to use the
cold bath. It is always to be followed by brisk rubbing with a coarse
towel or flesh-brush.
The Sponge Bath. — A wet sponge is the simplest, as well as the
best mode of applying water to the surface of the body. With per-
HYGIENE.
115
sons who are feeble, a part only of the body should be exposed at a
time, — which part, having been quickly sponged and wiped dry,
should be covered, and another part exposed, and treated in a like
manner. In this way, all parts of the body may successively be sub-
jected to the bracing influence of water and friction, with little risk,
even to the most delicate, of an injurious shock. The only furniture
required for carrying out this simple plan of bathing, is a sponge, a
basin, and a towel. There is no form of bathing so universally appli-
cable as this, or so generally conducive to health.
The Shower Bath requires a brief notice. The shock to the ner-
vous system produced by it much greater than that from sponging.
Beside the sudden application of coldness, there is a concussion of
the skin by the fall of the water. This form of the bath is excellent
for those who are strong and full of vitality, but is fraught with some
danger for the feeble and delicate. This, however, depends on the
judgment with which it is used. In the form of a delicate shower,
and with tepid water, the frailest body might bear its shock.
The Warm Bath; — A temperate bath ranges from 75° to 85°; a
tepid bath, from 85° to 95° ; a warm bath, from 95° to 98° ; a hot
bath from 98° to 105°. A warm bath is of the same temperature
with the surface of the body. Of course it produces no shock. To
those who are past the meridian of life, and have dry skins, and begin
to be emaciated, the warm bath, for half an hour, twice a week, is
eminently serviceable in retarding the advances of age.
It is a mistake to suppose the warm bath is enfeebling. It has a
soothing and tranquillizing effect. It renders the pulse a little
slower, and the breathing more even. If the bath be above 98°, it
becomes a hot one, and the pulse is quickened.
The temperature of the warm bath, as of the cold, should be made
to range up and down according to the vigor of the frame, and the
circulation of the individual. The aged and the infirm, whose hands
and feet are habitually cold, require it to be well up towards the
point of blood heat. The pulse should not be made to beat faster by
it, nor should sensations of heat or fullness be induced aboub the
temples and face.
The Vapor Bath. — This differs from the warm bath in being ap-
phed to the interior as well as to the exterior of the body. The
warmth is inhaled into the air-tubes at the same time that it envelops
the external person. The first sensation of the vapor bath is oppres-
sion, and causes some difficulty of breathing ; but this passes off as
soon as the perspiration begins to flow. From the steam-chamber,
the bather should step into a tepid bath, and after remaining a short
time in this, wipe himself thoroughly with dry towels.
Cold Affusion immediately after either the warm or the vapor bath,
is excellent. In Russia it is common, after the vapor bath, to pour
116
HYGIENE.
upon the head of the bather a bucket of warm water, then one of
tepid, and lastly one of cold ; and to finish with giving him a good
towelling. It is even said that the natives leave the steam and the
hot bath, and roll themselves in the snow.
No danger need be feared from cold affusion when the skin is red
and excited by the warm bath, provided the nervous frame is not in
a depressed condition. If the body is chilled, and the nerves pros-
trated by disease or fatigue, the application of cold water to the skin
may do great mischief, and should in no case be hazarded. Cold
water applied to a hot skin cannot do harm ; to a cold skin, it can do
nothing but harm. Hence, the cold bath may be used with advan-
tage on rising in the morning, while the body is warm. Another good
time is at ten or eleven o’clock in the forenoon, when the nervous
power is advancing towards its height for the day.
Reaction Necessary. — As a means for promoting cleanliness, the
importance of the bath can hardly be overstated. For the support
and improvement of health, it is equally important. But for the pro-
motion of the latter, one prerequisite is essential, — the reaction of
the skin.
Various means are resorted to, to secure this. The Hindoos secure
it by a kind of shampooing, thus described by a writer : “ One of the
attendants on the bath extends you upon a bench, sprinkles you with
warm water, and presses the whole body in an admirable manner.
He cracks the joints of the fingers, and of all the extremities. He
then places you upon the stomach, pinches you over the kidneys,
seizes you by the shoulders, and cracks the spine by agitating all the
vertebrae, strikes some powerful blows over the fleshy and muscular
parts, then rubs the body with a hair-glove until he perspires,” etc.
“ This process,” says the writer, “ continues for three-quarters of an
hour, after which a man scarcely knows himself ; he feels like a new
being.” Sir John Sinclair speaks thus of the luxury of the process:
“ If life be nothing but a brief succession of our ideas, the rapidity
with which they now pass over the mind would induce one to believe
that in the few short minutes he has spent in the bath, he has lived a
number of years.”
The Coarse Towel, the horsehair glove, and the flesh-brush are the
appliances commonly used for stimulating the skin, and causing re-
action. For tender skins, the towel is sufficiently rough. With this
the bather should rub himself, unless he is weak and the exertion
produces palpitation. The muscular exertion necessary for this will
help the reaction.
Restoration of the Bath desirable. — It is greatly to be wished
that the bath might be restored to something like the importance it
held among ancient nations. It is a luxury, a means of health, and
a source of purity both of body and of mind ; for the morals of any
people will rise where the use of the bath is regular and habitual.
HYGIENE.
117
The attempt to cure all diseases by what is called the “ water-cui’e,”
has a bit of fanaticism about it, which will cure itself in time. But
that water, used judiciously in the form of baths, is a potent moral
and physical renovator of the race, is not to be doubted ; and this
should commend it to all sensible people, even though it should some-
times be abused by excess, as all good things are.
A people with clean hands, and clean bodies, and clean health, will
very naturally come to like clean streets and clean cities, and finally,
clean consciences. A fondness for cleanliness in one form, almost ne-
cessarily runs into a like fondness for it in other forms, until the pu-
rifying desire pervades the whole nature, moral as well as physical.
Air and Ventilation.
Wateh and air are fiuids. Water covers two-thirds the surface of
the globe, having a depth, in some places, of five miles or more. Air
covers not merely the remaining third of the earth, but the water as
well. It embraces the entire globe, pressing alike upon land and
water, and having a depth of about forty-five miles. This is a sea of
such magnitude, that the Atlantic or Pacific shrinks to a very small
lake in the comparison.
Man has his residence, and walks about at the bottom of this ocean.
He has no means of navigating it, and, therefore, never rises to its
surface ; but, with his natural eyes, and with telescopes, he discovers
objects which lie millions and billions of miles beyond it, and even
acquires much exact and useful information respecting them.
This vast ocean of air we call an atmosphere., from two Greek words
signifying vapor, and a sphere, — it being an immense fluid-sphere, or
globe.
Pressure of the Atmosphere. — This atmosphere presses upon man
and upon every object on the surface of the earth, with a force equal
to fifteen pounds to every square inch ; and as a man of average size
has a surface of about 2500 square inches, the air in which he lives,
presses upon him with a weight of eighteen tons. This would of
course crush every bone in his body, but for the fluids within him
which establish an equilibrium, and leave him unoppressed.
The Philosophy of Breathing cannot be fully explained in the
brief space allotted to this subject; it is enough to say, that, upon
the attempt being made to draw in the breath, the muscles of the
breast draw up the ribs, the diaphragm or midriff at the same time
contracting, — the whole movement being such as to create a vacuum
in the lungs. The air, pressing upon every part of the surface, as
mentioned above, rushes in and fills the vacuum. The lungs being
filled, the contraction of the muscles of the belly causes the dia-
phragm, which has sunk down towards a plane, to rise up into the
form of an umbrella, and squeeze the air out of the lungs.
118
BYGIEITE.
This is about all that need to be said of the method of getting the
air into and out of the lungs. The whole process is under the con-
trol of that part of the nervous system called the medulla oblongata,
or the top of the spinal cord.
Objects of Breathing. — There are at least three objects to be ac-
complished by breathing ; the renewal of the blood and the taking of
impurities out of it ; the warming of the body ; and the finishing up
of the process of digestion, and the change of chyle into nutritive
blood.
There is no good reason for attempting here to explain the last of
these objects. To give any idea of the first two, it is necessary to
furnish a very brief explanation of the circulation of the blood.
The heart is double. There are in fact two hearts, a right and a
left, joined together. The right heart receives the blood from the
veins, and forces it up into the lungs, whence it is brought back to
the left heart, and by this is driven through the arteries into every
part of the body. When received into the lungs, the blood is of a
dark purple color, and is loaded with carbonic acid and some other
impurities. It has also been deprived, during its circulation through
the body, of most of its oxygen. The small, delicate vessels which
convey this dark and impure blood through the lungs, pass directly
over the air-cells ; and at this moment the carbonic acid and water
pass through the blood-vessels and air-cells, and are borne from the
body on the outgoing breath ; while the oxy-
gen enters the blood through the walls of the
same vessels ; and this exchange, which takes
place with every breath, alters the blood from
a dark purple to a scarlet red. Fig. 71
shows at 1, a bronchial tube divided into three
branches ; 2, 2, 2, are air-cells ; 3, branches of
the pulmonary artery winding around the air-
cells with the dark blood to be reddened.
That carbonic acid and water are borne out of the lungs with every
breath, may be easily proved. If we breathe into lime-water, it will
become white. This is owing to the carbonic acid in the breath unit-
ing with the lime, and producing carbonate of lime. Then, if we
breathe upon a piece of glass, it becomes wet, showing that there is
watery vapor in the breath. That the blood receives oxygen from
the air we breathe is proved by the fact that the ingoing breath has
one-fourth more oxygen in it than the outgoing.
The lungs, then, take out of all the air we breathe, one-fourth of
its oxygen. If we breathe it over a second, a third, and a fourth
time, it not only has less oxygen each time, and is less useful for the
purposes of respiration, but it becomes positively hurtful by rea-
son of the poisonous carbonic acid wliich, at every outgoing breath,
it carries with it from the lungs.
Effect of -Sleeping in a Small Room. — Now, consider the effect of
Fig. 71.
HYGIENE.
119
sleeping in a small room, seven feet by nine, not furnished with the
means of ventilation. A pair of lungs, of ordinary size, take in, at
each breath, about a pint of air. Out of this air one-fourth of its
oxygen is extracted ; and when it is returned from the lungs, there
comes along with it about eight or nine per cent of carbonic acid.
As it is not safe to breathe air containing more than three or four
per cent of this gas, the pint which the lungs take in and throw out
at each breath is not only spoiled, but it spoils something more than
another pint with which it mingles ; and as the breath is drawn in
and thrown out about eighteen times per minute, not less than four
cubic feet of air is spoiled in that time by one pair of lungs. This is
two hundred and forty feet an hour ; and in eight hours, the usual
time spent in the sleeping room, it amounts to one thousand nine
hundred and twenty cubic feet. During the hours of sleep, therefore,
one pair of lungs so spoil one thousand nine hundred and twenty
cubic feet of air that it is positively dangerous to breathe it.
In a room seven feet by ten, and eight feet high, there are five
hundred and sixty cubic feet of air, a little more than one-quarter
the amount spoiled by one pair of lungs during sleeping hours. In
a room of this size, there is not air enough to last one person three
hours ; and yet two persons often remain in such rooms eight or nine
hours.
Why then do they not perish ? Simply because no room is entirely
air-tight. Fortunately, all our rooms are so made that some foul air
will get out, and a little that is pure will find its way in. Were it
not so, no man who closed the door behind him,’ for the night, in a small
bed-room, would ever see a return of day.
Suppose fifty children are confined in an unventilated school-room,
twenty feet by thirty, and ten feet high. These children will spoil
about one hundred and fifty feet of air in one minute, or nine thou-
sand feet per hour, or twenty-seven thousand feet in three hours, — a
usual half-day’s session. But the room holds only six thousand cubic
feet of air, — the whole of which these children would spoil in forty
minutes.
These simple facts show the absolute necessity of ventilation. Yet
how poorly it is provided for in our sleeping rooms, our sitting rooms,
our school houses, our churches, our court houses, our halls of legis-
lation, and even in our anatomical and medical lecture-rooms !
In sick=rooms, ventilation should .receive special attention. —
Every disease is aggravated by the breathing of bad air. Yet it is
common to close all the doors and windows of rooms where sick per-
sons are confined, lest the patients should take cold. This is a bad
practice. The sick should have plenty of fresh air. Their comfort
is promoted by it, and their recovery hastened.
It is strange that human beings should be afraid of pure air. It
is their friend and not their enemy. Impure air only should be
shunned.
120
HYGIENE.
The supply of good air ample. — There is no necessity for breath-
ing air which has lost a part of its oxygen, and acquired a portion of
carbonic acid. The supply of good air is ample. An ocean of it
forty-five miles deep, covering the whole globe, seems a pretty plain
intimation that it is not to be sparingly used. When men retire
within their dwellings, and attempt to shut out this great sea of air,
they show about as much wisdom as would be exhibited by fishes
which should build water-tight huts around themselves at the bottom
of the ocean, and swim about continually in the unchanged water
within. Fishes can only live in glass globes when the water is
changed every day ; and if the water be changed half a dozen times
a day, they cannot be as healthy as when swimming in the great
ocean.
Cultivating Trees. — In most of our cities there is almost a crimi-
nal neglect of the cultivation of trees ; yet they add greatly to the
health, and prolong the lives of the citizens.
The leaves of a tree are the lungs with which it breathes ; but in-
stead of extracting oxygen from the air, and giving back carbonic
acid, like man, it takes only the poisonous carbonic acid, and gives
back oxygen.
Were there no animals on the globe, the vegetables would con-
sume all the carbonic acid, and die for want of breathing maf^erial ;
on the other hand, were there no trees or other vegetables, the ani-
mals would in time so far exhaust the oxygen as to perish for lack
of it. The two together keep the air healthy for each.
The relation of plants and animals, in all that relates to their
peculiar a,ctions and effects, is a complete antagonism. Their move-
ments are in contrary directions, and by hostile forces. Their oppos-
ing actions may be illustrated thus : —
The vegetable pkoduces the non-
nitrogenized substances, sugar, starch,
and gum.
The vegetable decomposes carbonic
acid, water, and ammoniacal salts.
The vegetable disengages oxygen.
The vegetable absokbs heat and
electricity.
The vegetable is a de-oxidizeb.
The vegetable is stationaey.
The animal consumes the non-ni-
trogenized substances, sugar, starch,
and gum.
The animal produces carbonic acid,
water, and ammoniacal salts.
The animal absorbs oxygen.
The animal produces heat and
electricity.
The animal is an oxidizer.
The animal is locomotive.
We learn from the facts of Geology that the time was in the his-
tory of our globe, when lunged animals could not breathe its atmos-
phere; it was too much loaded with carbonic acid. The trees then
grew with a rapidity almost inconceivable, decomposing the poison-
ous gas, taking to themselves the carbon and setting the oxygen
free, and lifting up their brawny arms to heaven in acts of thankful-
ness for the great feast.
At length the noxious gas was exhausted; and then, pale and
sickly, they feebly held up their hands for help; and God sent num-
berless tribes of warm-blooded animals, full of life and energy, that
HTGIEKE.
121
«ported in the exhilarating air, and destroyed vast forests, thereby
reproducing carbonic acid.
These simple facts should teach man the sanitary importance of
trees and bushes ; and wherever he has a rod, I had almost said a
foot of ground to spare, a tree should be planted and carefully
nursed. This is particularly necessary in large cities. Every narrow
street in a city should be lined with trees. For their absence, thou-
sands of men, women, and children have died sooner than they
otherwise would. We want them stretching up their arms to all
our windows to give us oxygen, and to take to themselves the car-
bonic acid we exhale.
Tight Dresses. — The health may be injured by not breathing air
enough, as well as by inhaling that which is impure. It is therefore
improper to compress the lungs by wearing tight dresses. If the
ribs are held down by the dress, but little air can get into the lungs,
and only a small amount of carbonic acid can be carried out. In
this event, the health is injured in two ways : the blood is not vital-
ized by oxygen received, and it is poisoned by carbonic acid retained.
Tight lacing has in a measure gone out of fashion ; yet too much
of it for the best development of female health is yet retained. As
a knowledge of physiology and the laws of life, and a better judg-
ment of the true symmetry of the female form prevail, this barbar-
ous custom will pass out of use, and the substantial health and
real beauty of the American woman will together rise to a higher
standard.
Fill the Lungs well. — Persons who take but little exercise are
apt to acquire the habit of drawing the air very little into the lower
part of the lungs. This should be counteracted by taking long and
full inspirations for a short time, every day, while in the open air.
This practice would get the lungs in the habit of opening to the air
quite down to their base, and would make the breathing much more
natural as well as effectual at all times. In the case of young per-
sons, it would enlarge the capacity of the chest, and add to the brief
years of life. Parents should see to it that their children spend
from ten to twenty-five minutes every morning inflating their lungs
with pure air.
Travell ing.
It is true that many persons who dwell in one spot, and hardly
move from it all their lives, live to old age. Yet change of location
for a short time, or permanently, does promote health, and protract
life. The mind tires of contemplating one set of objects for a great
length of time ; and in the absence of all stimulation, it sinks into
apathy, and imparts no energy to the body. The physical frame,
partaking of the ennui of the mind, droops. This is doubly true
when one is suffering from illness.
122
HYGIENE.
Travelling is eminently fitted to draw the thoughts of the nervous
and feeble from themselves, and to turn them with interest to out-
ward objects. This is of great importance. It is better than stimu-
lants and tonics.
The nervous system has great power over the health; and the
pleasurable sensations, excited by visiting new places and scenes,
and conveyed to the mind through the nerves, often awaken in the
constitution energies which are essential to recovery.
Travelling places a man in entirely new circumstances. It sur-
rounds him with novelties, every one of which makes a demand upon
his attention. It breaks up his old trains of thought, which have
been monotonous so long that they have grown oppressive. It
causes the world to touch him at a thousand new points, and sur-
prises him every day, perhaps every hour, with a view of the false
relations he has sustained to it. It opens to liim new depth? in his
own nature, and causes him to wonder that they never attracted his
attention before. It opens to him one door after another, leading
him into new apartments of knowledge ; and as the world grows, he
finds himself growing with it, until his whole nature dilates and
beats with new life.
Means of Travelling Increased. — The last twenty-five years
have greatly increased the facilities for travelling. Many of the
sick may now seek health in distant lands, who, had their circum-
stances been similar twenty years ago, would have been compelled
to pine at home. The railroads give an easy journey to thousands
with the comforts of the parlor cars.
One thing more wanted. — But one thing is wanted to bring the
means of travelling, for the sick, very nearly to perfection ; it is a
method of propelling carriages upon common roads, by some cheap
power, which can never be exhausted, and which shall be easily man-
aged by the traveller or his companion. This is a prominent want
of the present hour ; a giant discovery, which, at a single stride,
would carry the world forward a hundred years, and which, we may
hope, is in the womb of the near future. The power, it is believed,
will be electromagnetism. The mode of applying it, when discovered,
will be simple, yet wonderful ; and the results to the sick, beneficent
beyond expression. The human mind cannot conceive the advan-
tages which invalids would derive from such a mode of conveyance.
Journeys might be long or short; might be made with any rate of
speed which the strength permitted. The morning or afternoon
stages might be discontinued when fatigue demanded, and resumed
at pleasure. Over uninviting regions the traveller might glide
swiftly, and linger where Nature spreads her feasts for the mind.
The best Seasons for Travelling are spring and autumn. Win-
ter is too cold. A pleasurable excursion may sometimes be made in
summer, but in general the season is too hot for comfort. In chang-
HYGIENE. 123
ing climate, food, water, etc., in the sultry season, there is danger of
contracting very troublesome bowel complaints.
Means of Travelling for the Poor. — There is one painful thought
connected with travelling as a means of health, — it cannot be en-
joyed by the poor. When sick they generally have the careful
attention of humane physicians ; they receive from kind neighbors
little delicacies of food and drink ; they are watched with by night,
and visited by day ; but though suffering from the hard routine of
a laborious life, and needing diversion and recreation more than all
else, they cannot travel. They have not the means, and nobody
thinks of supplying them for such a purpose.
This is a channel into which charity ought to pour some of its
benevolent streams. In large cities there is a class of poor females
who sit in their small rooms and ply the needle diligently through
the whole year, and who run down every summer very near to con-
finement in bed. Two or three weeks, in the hot season, spent in
travelling in the mountains and elsewhere, would bring back the
color to the pale cheeks of such persons, and save them many years
both from the grave and from the almshouse. No millionaire could
make a better use of property than to set it apart, at his death, for
the specific purpose of enabling the poor to travel. And if this
suggestion should induce one rich man to consecrate his wealth to
the Godlike work of bestowing health, happiness, and intelligence
upon the poor, the great labor of preparing this book will not have
been endured in vain.
Amusements.
That which engages the mind, and at the same time impresses it
with pleasurable sensations, is a sufficiently accurate definition of
amusement. Whatever occupies the thoughts and senses in an
agreeable way, and employs them with some degree of intensity,
comes under the same head.
This broad and general definition allows us to disregard our daily
employments as amusements when they engage our deep attention
and at the same time give us pleasure.
The term “ amusements,” however, in the more popular sense, is
restricted to those sports, games, plays, exhibitions, entertainments,
etc., which involve a suspension of our daily labors, and are properly
called diversions.
When nature is tired and worn with those severe and exhausting
toils by which we earn our bread, amusements turn us aside, divert
us, engage other powers, and allow our tired faculties to rest. They
are, therefore, of very great importance. Even the most trifling
amusements may have the highest value. Their very nature and
object imply that they will be valuable just in proportion as they
divert and rest us. And just in proportion as they do these things,
they give us health.
124
HYGIENE.
One other thing amusements do for us, which must not be forgot-
ten ; they preserve in us, in middle life, and even in old age, the
warm simplicity of childhood. They keep us young in our disposi-
tions and feelings. They keep us in harmony with nature, and con-
sequently artless and truthful. They prevent the formalities of con-
ventional life from stiffening us into cold and repulsive hypocrites.
Selection of Amusements. — Of course the same amusements are
not adapted to all persons. The farmer who has worked his muscles
all day, would not be benefited by a game of ball in the evening ;
yet there are few games more suitable for the student who has bent
for many hours over his books. Care should always be taken, there-
fore, that amusements or sports do not bear upon those limbs or
faculties which are wearied by work.
Amusements improve various faculties. — To one who has a
taste for art, who is fond of works of genius and poetry, theatrical
entertainments will always be agreeable, and a source of gratification
and health. I know these exhibitions are objected to by many as
immoral and hurtful, but more, I think, from habit and fashion, than
upon any solid grounds of reason or religion. They certainly appeal
to a high order of faculties in the human mind ; and to those who
are fitted to receive them, teach lessons of great moment. Even the
lower exhibitions of comedy, though not particularly improving to
the mind, are yet, from their power to provoke Imighter, among the
most powerful up-builders of health. ■ ,
The Games of Whist, Euchre, etc., engage the minds of the play-
ers in a sort of mental contest, which is exciting, agreeable, and .
health-imparting. These games make us skilful in calculating
chances, and judging how men ought to act under certain contin-
gencies. They make us sharp to detect and turn aside the unseen
forces, which tend to oppose and destroy our success in life.
I hardly need to say that money or rather property should never
be staked upon a game of cards, or upon any other game. Gambling
is one of the meanest as well as most destructive things in which men
can engage. It raises the healthful excitement of these innocent
amusements, — innocent when properly pursued, — into raging pas-
sions, which, when defeat comes, as come it will, sink into remorse
and bitterness as terrible as the mind can conceive. I warn young
men, as they would escape the pangs of a hell on earth, and the loss
of character, happiness, and probably health for life, to avoid any
such abuse of cards.
Chess, Chequers, etc., appeal likewise to the fondness of competi-
tion, which is common to all men. But they cultivate in us a little
more of the mathematical element. As they require very close appli-
cation of the mind, they are not suitable for persons of sedentary em-
ployments, or whose daily avocations require a constant use of the
HYGIENE.
125
mind. Such persons should choose lighter and more active amuse-
ments.
Lighter Amusements. — Beside these higher amusements, there
are a great number of lighter and more childish ones, which should
not be overlooked.
Some of these are merely physical, involving a trial of strength,
fleetness, action, etc., as the games of ball, cricket, etc. Others are
domestic in their nature, involving mirth, and various other of the
lighter excitements, as blind-man’s buff, puss in the corner, hole in the
wall, fox and geese, hunt the slipper, hurly-burly, roll the platter, etc.
In fashionable American households, these simple domestic plays
have in a great measure gone out of use, — being deemed vulgar, and
below the dignity of ladies and gentlemen. I am sorry to say this ;
for the vulgarity, in my judgment, is in those who reject them, and
not in the play.
The officer of our navy, whose visit to the mansion of Lord Hard-
wick I have spoken of on page 93, reports that on the evening of one
of his visits, the play of blind-man’s buff was engaged in by the whole
party ; and that his Lordship in attempting to make a short turn dur-
ing the play fell upon his back, when one of his daughters, who was
blinded, caught him by the heels, and being assisted by others, drew
him feet-foremost half the length of the hall, amid the shouts of the
whole party. Th;s would have been deemed very vulgar by fashion-
able people in this country. But to me, who am no believer in any
nobility which Lord Hardwick can receive from kings or queens, this
simple narrative raised him at once to a peerage in nature’s realm.
Without doubt, he is one of nature’s noblemen. A man in his sta-
tion, and with his wealth and temptations to snobbery, who can pre-
serve such simplicity of character, must have a warm as well as a
noble heart in his breast.
Value of Domestic Amusements. — I remark here that, in all our
amusements, we should, as far as possible, seek those of a domestic
character. They are more simple and childlike in their nature, and
preserve in us, even to old age, the freshness of feeling, and truthful
simplicity, which spread so beautiful a greenness over the autumn of
life.
Simple domestic amusements, too, are always gotten up on a cheap
scale; they do not encourage costly extravagance, and can be in-
dulged in by the poor as well as the rich.
But more, and better than all, they keep young men and old men,
and young women and old women, at home, by making the domestic
circle the centre of attraction. They draw the seekers of pleasure
around the hearth-stone, instead of outward in the world. They in-
cline young and old to look to the family circle as the centre of the
most pure, because the most simple and natural, enjoyments. They
teach us to look to home as the centre of life, and to all outside as
only its appendages.
126
HYGIENE.
It has been said that homes are found only in England ; that in
other countries, life wanders, houseless and shelterless, abroad, seek-
ing happiness, it knows not where, while in England it nestles warmly
in the bosom of home. To whatever extent this is true, — and I be-
lieve there is truth in it, — it is owing to the simple household amuse-
ments of England.
An American Want. — One of the great wants of this country is a
more liberal provision for amusements. We attach here too much
value to wealth ; and we pursue it with an intensity altogether in-
compatible with health. W e cannot take time for recreation because
we are in so great a hurry to be rich.
If we would save ourselves from a total wreck of health, we must
take broader and better views of life. We must value it for its solid
comforts, rather than for its glitter and show.
Contrary to the general belief, insanity is very prevalent among
seamen and farmers. The former lead a life of dreary solitude upon
the ocean ; the latter, one, if not of equal, certainly of very objection-
able solitude upon the land. The sailor who does business upon the
great sea should provide himself with great numbers of games to
amuse him in his wanderings. The farmers of our land should cul-
tivate more of the sociabilities of life. Let them meet together in
the fine summer evenings, like the peasants of France, and dance
upon the green lawns before their cottages. They will till their lands
more cheerfully for it ; enjoy better spirits and health ; and live to
greater age.
Completeness of Life. — Amusements are necessary in order to
give a completeness to life. The faculties of the human mind are
numerous. It is only when they are all exercised, in their due pro-
portion, that there is a harmonious beauty in our lives. The cus-
toms of society twist us all out of shape, — perverting us mentally,
morally, and physically, and robbing us of every manly and health-
ful quality. Getting out of the ruts of fashionable life, we must
come back to the simple paths of nature.
I would strongly impress upon parents, teachers, and guardians,
the importance of studying well the various temperaments, physical
and mental peculiarities of their children, in order to judge wisely
of the kind and amount of recreation required by them.
Instance : a pale, delicate child of ten to twelve or fourteen years,
with clear complexion, flaxen hair, blue eyes, slender frame, and a
nervous, sensitive organization, with strong mental cast, requires
much more recreation and out-door exercise than a full-blooded,
robust child of that age ; a fact not at present duly considered, as a
general thing.
TEMPERAMENTS
AND
CONSTITUTION of the BODY
AND
SYMPTOMS of DISEASES
%
It is necessary that the reader should understand the temperament
and constitution of the body and symptoms of diseases
that they may intellig^ently diagnose
the case.
TEMPEEAMENTS, CONSTITUTION, AND
SYMPTOMS.
Man has thinking^ warming, nourishing, and moving powers. For
the performance of each of these great functions, he has organs of
the best possible construction.
For Thinking, he has a hrain. If this be large in proportion to his
other organs, it gives a character, a cast, a peculiarity to his whole
organization. Everything about him is subordinate to his brain.
We recognize him, at once, as a thinking and feeling being. He
has an intellectual look. There is a delicacy, a refinement, a sensi-
tiveness, a studious habit, an air of thoughtfulness about him, which
determine his traits, his tone, his temper, his whole character. Hence
it is proper to say he has a cephalic or thinking temperament.
The Lungs and Heart, devoted to renewing and circulating the
blood, are placed in the chest or thorax. If these he large in man in
proportion to other organs, he is characterized by great activity of cir-
culation, by a large supply of red blood, and by the general indica-
tions of a full, warm, and bounding life. This activity gives him
his tone and temper, and shows that his is the thoracic or calorific
temperament.
In the Great Cavity of the Abdomen is done the work of receiv-
ing, digesting, and disposing of the materials which nourish the body.
If the organs which do this work be large in proportion to others, the
body is fed to repletion, and the whole organization speaks of the
table. The habit, the look, the temper, are all sluggish. This is the
abdominal or alimentary temperament.
The Bones and Muscles are instruments by which the movements
of the body are performed. If these be the largest, in proportion, of
any in the body, then the locomotive powers are in higher perfection
than any others. There is largeness of person, energy of movement,
and greatness of endurance. The whole cast of the person partakes
of the strength and coarseness of bone and muscle. This is the
muscular or locomotive temperament.
This gives us four temperaments, as follows : —
I. The Cephalic Temperament, denoted by large brain, activity of
mind, and general delicacy of organization.
128
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
129
II. The Thoracic Temperament, indicated by a large chest, force
of circulation, redness of skin, great activity, warmth of temper,
and fulness of life.
III. The Abdominal Temperament, denoted by a large develop-
ment of the stomach, liver, bowels, and lymphatics ; by ,a fulness of
belly, fondness of high living, and a disposition to float sluggishly
upon the current of the world, rather than to struggle against it.
IV. The Muscular Temperament, indicated by largeness of frame
and limbs, coarseness of structure, and great power of locomotion
and endurance.
There are some reasons for reckoning but three temperaments in-
stead of four, by reducing the thoracic and abdominal to one, after
the manner of the phrenological Fowlers, — especially as the organs
in the chest, and their appendages, take an important part in the
process of nutrition. But as the heart and lungs are placed in one
cavity, and the stomach, liver, etc., in another, and as one set of
these organs may be largely developed, and the other defectively, I
have thought it most convenient, on the whole, and quite as philo-
sophical, to retain the four temperaments.
These temperaments seldom or never appear single and pure.
They mix and cross with each other in all possible ways.
Medication and Temperaments.
The object of speaking of temperaments in this work is to make
the reader acquainted with the principles upon which remedies are
to be adapted to their development. The philosophical-minded phy-
sician will, in prescribing, always keep the temperament in view.
Persons of a Cephalic Temperament cannot bear powerful medi-
cines, — particularly drastic purges. Their fine, delicate and sensi-
tive organizations would be torn all to pieces by doses which would
hardly be sufficient in a fully-developed muscular temperament.
This should always be borne in mind in prescribing for persons of a
large brain and delicate organization.
In this temperament, too, fevers, instead of running a high and
fiery course, take the low typhoid type, the patient becoming pale,
and showing a constant tendency to sink. Such patients would be
killed by purging, leeching, cupping, sweating, and starving. They
want tonics, stimulants, and every kind of support which the case
will possibly permit.
Persons of a Thoracic Temperament, having a rapid circulation,
and a fulness of blood, are most liable to iriflammatory diseases.
When fever attacks them, they have what is called a “ high fever.”
If rheumatism comes, it is acute rheumatism. Disease takes hold of
them smartly- As they do everything with emphasis and energy
130 TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
when well, so, when ill, they make a business of it, and are sick with
all their might.
Stimulants and tonics generally make such persons worse. They
want sedatives, and diaphoretics, and sweats, and purgatives, and
leeches, and cups, and low diet, and cold bathing, and whatever else
will slacken the ferocious swiftness of their circulation.
Those of the Abdominal Temperament are not particularly sub-
ject either to very high fevers, or to those typhoid forms which
produce sinking. As in the two temperaments noticed above, their
complaints chiefly attack the organs most largely developed. Their
diseases affect the stomach, the liver, the spleen, and the bowels.
These are the largest organs in their bodies, and are most used ; and,
being overworked, they fall into disease.
As these persons are slothful in all their habits, so their diseases
run a sluggish course. They are not so liable to sudden death as
persons of either of the preceding temperaments. They have all
sorts of chronic diseases which linger a great while, and are cured
with much difficulty.
These persons will bear larger doses of medicine than either of
the preceding. Neither do their constitutions respond as readily to
medicine. A physician will be disappointed if he expects to see
them recovering as fast under its use.
Those of a Muscular Temperament, having little fondness for
anything but a hardy, active life, are much exposed to the elements.
Though strong and long-enduring, the hardship of their lives often
breaks them down, and when felled by disease, they are oftentimes
shockingly racked and torn by it.
These persons bear large doses of medicine, and when sick, need
to be treated with an energy proportioned to the strength of their
constitution. Rheumatism, which affects the joints, the ligaments,
and the tendons, is an affection from which they suffer severely.
The Constitution.
In prescribing for disease, it is of very great importance to take
notice of the constitution. This is a different matter from the tem-
peraments. Persons of the same temperament are often quite unlike
in the strength of their constitution. And those having good natural
constitutions, frequently abuse them by improper habits and indul-
gences, and at length come to have broken and very feeble consti-
tutions.
Some persons’ muscles and other tissues are put together as if
they were never intended to come apart. Like some of the woods
of the forest, — the lignum vitse for example, — they are fine-grained
and tough. A real smart boy will Avear out an iron rocking-horse
sooner than one of these persons can exhaust their constitution by
TEMPBKAMENTS, CONSTITUTION, AND SYMPTOMS. 131
hard work. Others, to outward appearance equally well made, have
very little endurance, break down easily under hard work, and lose
their flesh from trifling causes.
The state of the constitution, therefore, should always be learned
before much medicine is given ; for what a person of a strong con-
stitution will need^ may greatly injure a feeble person, even of the
same temperament.
Habits. — These must likewise be attended to. Persons using
stimulants require larger doses of medicine to affect them than other
persons.
Climate. — Medicines act differently on the same persons in sum-
mer and winter. Narcotics act more powerfully in hot weather and
climates than in cold, and must be given in smaller doses.
Idiosyncrasy. — Medicines of only ordinary activity, act very pow-
erfully, and even violently on some persons. This is owing to a pecu-
liarity of stomach, or constitution, called idiosyncrasy. It makes the
person, in this particular, an exception to the general rule. And no
physician can know beforehand in what particulars this exceptional
disposition will show itself. Persons, however, learn their own idio-
syncrasies, and should make them known to those who prescribe for
them for the first time.
The Sexi — The peculiarities of each sex should never be forgotten
in prescribing for the sick.
Males are not so sensitive as females. They will bear more medi-
cine, and their nervous system is not so readily excited by it.
Influence of Age. — Human life is divided into infancy, childhood,
youth, manhood, and old age. Each of these periods has peculiarities
which modify disease.
The First Period, extending from birth to the age of seven years,
is marked by tenderness and excitability, and is alive to every irrita-
tion. Teething and other disturbances occur at this period, and need
careful management.
The Second Period extends from seven to fourteen, and is quite
subject to disease, including the second dentition. During these two
periods there is no great difference between the sexes ; both are ten-
der, and need careful watching.
During the Third Period, the changes occur which mark and sepa-
rate the sexes. This is a developing period, when the functions be-
come established, and the frame acquires form, proportion, and
strength.
At this time, hereditary tendencies to disease, latent till now, begin
to show themselves, and call for every possible endeavor to break
them up, and fortify the constitution.
132
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
The Fourth Period embraces the vigorous maturity of life, when
the powers of body and mind, in both sexes, are at the summit of
their excellence. The functions are now well established. It is dur-
ing this period that the female is subject to most of the harassing
ailments peculiar to her sex. So numerous are these complaints, and
so large and valued the class of persons affected by them, that he who
treats them with the greatest skill, and with the delicacy which their
.(lature demands, may be said to be at the head of his profession.
The Fifth Period is that of old age, when the functions are declin-
ing, and the frame is bending under the weight of years. Old age
begins earlier with females than with males. Many ailments are com-
mon to this period, which require peculiar managemept, both medi-
cinal and hygienic.
Proper Frequency of Dose. — Each succeeding dose should be
given before the effect of the preceding is gone. If this rule is not
attended to, the cure does not advance. What is gained by each
dose is lost by the rallying of the disease in the interval. Care must
be taken, however, not to apply this rule too strictly with very active
medicines.
How to Examine a Patient.
When a patient is presented for examination, having observed the
temperament, constitution, sex, and age,
1. Learn the causes of the disease, whether local, specific, or gen-
eral, and also its history.
2. Search out its nature and character, whether febrile or other-
wise.
3. Take notice of the whole train of symptoms, — embracing the
pulse, the condition of the mouth, tongue, and digestive organs, the
breathing, the urine, the fecal discharges, the condition of the brain
and nervous system, the state of the skin, etc.
Brief Table Explanatory of Symptoms.
GENERAL APPEARANCE OF PATIENT.
1. Tonic spasm of the trunk
2. Distorted features, altered position,
and impaired motion of limbs
3. Irregular and perpetual motion
4. Entire and absolute immobility
5. Great and unnatural boldness
6. Great and unusual languor
7. Ability to lie only upon the back
8. Lying upon the face
9. Lying upon one side
Locked jaws.
Paralysis of one side.
St. Vitus’s dance.
Catalepsy.
Insanity or delirium.
The beginning of an acute disease, or
the progress of a chronic one.
Apoplexy. Organic disease of the brain
or spinal marrow. Acute inflamma-
tion of the lining of the abdomen.
Rheumatism of the joints.
Several kinds of colics.
Pleurisy, or inflammation of the lungs.
When one lung only is affected in
consumption, the patient generally
lies on the diseased side.
indicates
it
TEMPEEAMENTS, CONSTITUTION, AND SYMPTOMS.
133
20. Maintaining the sitting posture
only
11. The head thrown back
12. Bestlessness and tossings
13. General enlargement of the body
Head, Face,
Disease of the heart or lungs, which
interferes with breathing.
Severe diseases of the larynx and wind-
pipe.
The beginning of acute inflammation.
Fevers. Delirium, and acute mania.
Cell-dropsy. Emphysema from a
wound of the chest,
and Neck.
indicates
1. Head bent to one side indicates Convulsions. Paralysis of one-half the
body. Dislocation of bones of neck.
2. Head increased in size
3. Swollen scalp
4. Dull expression of face
5. Pull, red face, with blood-vessels
of eyes injected
6. Pinched, contracted countenance
7. Pinched nose, sunken eyes, hollow
temples, skin of forehead tense
and dry, complexion livid
8. Wrinkles across the forehead
9. Wrinkles from forehead, vertically
to root of nose
10. A white line from inner angle of
the eye to just below the cheek-
bone
11. White line from the upper border
of the wing of the nose (ala nasi ) ,
curved to the outer margin of the
orb of the eye
12. The white line in children from
angle of mouth to lower part of
face
13. A white line external to the last
two, in a semicircular direction
towards the chin
14. Swelling of the face and eyelids
15. Transient redness or flushing of
16. Hectic flush
17. Paleness of face
18. Dingy, white, or greenish face
19. Yellow tint
20. A citron tint
21. A bluish tint
22. Perpetual motion of eyelids
23. Forcible closure of eyelids
24. Eyelids remaining open
25. Palsy of the upper lid
26. Flowing of tears over the cheek
27. Nostrils dilating forcibly and rap-
idly
28. Itching of nostrils in children
Swelling of glands of neck.
Chronic hydropholus. Enlarged brain.
Erysipelas. Small-pox.
Typhoid fever.
Swelling of heart. Congestion of
brain.
Acute inflammation of peritoneum.
Exposure to severe cold.
Chronic disease just before death.
Excessive pain arising externally.
Distress, anxiety, and severe internal
pain.
In children, a brain or nervous affec-
tion ; in adults, abuse of the genera-
tive organs.
In consumption and wasting of flesh.
The lower part of the line indicates
disease of stomach ; the upper part,
some affection of upper part of bowel.
When united with the white line
named above, and with a drawing in
of the cheek, fixed eyes, and a wan
complexion, it implies worms.
An affection of the chest, with difiB.-
culty of breathing.
Chronic and obstinate disease in the
chest or belly.
Albumen in the urine.
Suffering from the monthly irregular-
ity.
Consumption. Chronic affections.
Cold stage of fever. Acute inflamma-
tion. Chronic diseases, especially
Bright’s disease, during recovery.
A low and deficient state of blood.
Jaundice.
Cancerous disease.
Poor circulation in the veins. Cholera.
Typhus fever. Blue disease.
Mania and idiocy.
Intolerance or dread of light.
Orbicularis palpebrarum. Paralysis of
the muscle which closes the eye.
Injury of the third pair of nerves.
Obstruction of the lachrymal duct.
Difficulty of breathing.
Worms in the bowels.
The Tongue.
1. Surface of tongue covered with a indicates Derangement of stomach, or bowels, or
layer of whitish, soft, mucous both,
substance, which may partially
be taken off with a scraper,
also, clammy mouth
134
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
2. State of tongue as above, with
clammy mouth, bitter taste, and
fetid breath.
3. Great load on tongue as above,
which peels off, leaving the
tongue smooth, red and tender
4. Tongue slightly white from small
white points, and sometimes cov-
ered with fur, like the fibres of
coarse velvet
6. Tongue pale, tumid, clean and very
smooth
6. Tongue /M?red and
7. Tongue white and loaded, with
much thirst
8. As above at first, — afterwards
clean, red, and dry
9. Tongue white and loaded, with dry-
ness
10. Tongue dry, parched, tender, and
dark brown or black. Pushed out
with great difiiculty and tremb-
ling
11. Tongue loaded with white, through
which numerous elongated, very
red papillae protrude their points
indicates Acute dyspepsia. Asthma.
“ Severe cases of acute dyspepsia.
“ Chronic dyspepsia. Some affection of
the liver, if the fur be yellow.
“ Chlorosis or green sickness.
“ Violent local inflammation. Irritation
in bowels.
“ Inflammatory fever.
“ Protracted inflammatory fever.
“ Mild typhus fever.
“ Severer forms of typhus fever.
“ Scarlet fever.
The Throat.
1. Throat enlarged
2. Violent pulsation of carotid arteries
3. Pulsation of the nameless artery
(arteria innominata) above the
breast bone, and to the right of
the windpipe.
4 . Circumscribed swelling about throat
The approach of puberty in females.
Acute mania. Inflammation of brain.
Enlargement of heart, and dilation
of right ventricle. Anemia.
Regurgitation from aorta.
Enlargement of glands.
indicates
The Chest.
1. General enlargement of one side of
chest
2. Bulging at the base of a lung
3. Bulging at front upper part of chest
4. Bulging right hypochondrium (Sea
Fig. 95)
5. Bulging in region of heart
6. Tumor where the third rib joins the
breast-bone
7. Tumor between the base of the
shoulder blade and the spine
8. Depression or retraction of one side
of chest
9. Breathing increased in rapidity.
Generally, in health, about
twenty breaths are taken in a
minute
10. Breathing diminished in rapidity
11. Jerking respiration
12. Breathing with muscles of ribs only
The
indicates Large effusion of water from pleurisy.
“ Water from pleurisy settling to the
bottom.
“ Emphysema.
“ Enlargement of liver.
“ Water in heart-case. Enlargement of
heart.
“ Aneurism of the ascending aorta.
“ Aneurism of the descending aorta.
“ Consumption. Absorption of fluid,
effused by pleurisy.
“ Spasmodic asthma.
“ Pleurisy. Paralysis of respiratory mus-
cles. Inflammation of lungs. Emphy-
sema. Pneumothorax. Consumption.
“ Spasmodic asthma. Obstruction in
larynx and windpipe.
“ Abdominal inflammation. Inflamma-
tion of diaphragm.
Belly.
1. Increased size of belly indicates Dropsy. Wind in bowels. Inflam-
mation of peritoneum. Obstruction
in bowels. Hysteria.
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
135
2. Enlargement in epigastrium (Fig. 93) indicates Hysteria. Cancer of stomach.
3. Enlargement in hypogastrium (Fig. 95) “ Distension of bladder. Ovarian tu-
mors. Accumulation of feces in
bowels.
4. Belly diminished in size " Chronic dysentery. Lead colic. Also
in most chronic diseases.
t. Enlarged penis in children
2. Drawing up of testicles
3. Enlargement of scrotum
Private Organs.
indicates Stone in bladder. Masturbation.
“ Stone in kidneys.
“ Hydrocele. Hematocele. Sarocele.
1. The limbs immovable
2. Limbs contracted and rigid
3. General swelling of limbs
4. Swelling of joints
5. Limbs diminished in size
The Limbs.
indicates Paralysis.
“ Softening of the brain.
“ Defective circulation of blood.
“ Rheumatism. Water in the joints.
White swelling.
“ Paralysis.
The Nervous System.
1. Morbidly increased sensation
2. Tensive pain
3. Dull, heavy pain
4. Smarting pain
5. Shooting, tearing pains
6. Boring pains
7. Contusive pains.
8. Itching. Sensation as of ants creep-
ing over the skin
9. Exaltation of vision
10. Black flecks floating before the
eyes
11. Painfully acute hearing
12. Dull hearing
13. Increase of strength
14. Debility
15. Trembling
16. Rigidity of upper extremities
17. Cramp
18. Temporary spasm
19. Pain at extremity of penis
20. Pain in right shoulder
21. Pain in left shoulder
22. Exaltation of affections
23. Loss of moral sensibility
24. Exaltation of intellect
indicates Acute inflammation of brain and
spinal marrow. Fevers. Hysteria.
“ Phlegmonous inflammation.
“ Enlarged internal organs. Internal
tumor. Effusion of water into cavi-
ties lined with serous membranes.
Felt in the loins previous to dis-
charge from menstruation, and from
piles.
“ Scarf-skin removed.
“ Neuralgia. Cancer.
“ Constitutional syphilis. Rheumatism.
Gout. Inflammation of periosteum.
“ Bruises. Acute diseases.
“ Several diseases of the skin.
“ Ophthalmia. Inflammation of brain.
Some nervous diseases.
“ Affections of the brain and optic
nerve. Dyspepsia.
“ Inflammation of brain. Hysteria.
“ Typhus fever.
“ Delirium. Inflammation of brain.
Mania.
“ Most diseases.
“ Cold stage of fever. Nervous affec-
tions. Old age. Action on the sys-
tem of lead, mercury, strong coffee,
alcoholic drink, tobacco, opium.
“ Softening of the brain. Infiltration
of blood into the brain. Hysteria.
“ Pregnancy. Hysteria. Painters’ colic.
“ In convulsions of children. Some
affections of the brain.
“ Stone in bladder.
“ Congestion of liver.
“ Disordered stomach.
“ Hypochondriasis.
“ Mania. Typhus fever. Masturbation.
“ Melancholy. Sometimes indicates
close of life.
The Breathing.
1. Stiffness of chest indicates Cartilages turned to bone. Pleura
hardened. Distortion from rickets.
2. Pressure upon parts “ Tumors. Dropsy of belly.
V
136
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
3. Obstruction of air-tubes indicates Spasm of glottis. Spasm near the
small ends of bronchial tubes.
4. Compression of lungs
6. Pain in parts moved in breathing
6. Paralysis of muscles of chest
7. Spasm of muscles of chest
8. Deficiency of red blood
Mucus, etc., thrown out upon the
inner surface.
Effusions in pleurisy. Water in
chest. Air in substance of limgs.
Aneurism and other tumors.
Pleurisy. Inflammation of perito-
neum.
Injury of spinal marrow.
Locked jaw. Spasmodic asthma.
Anaemia, Chlorosis or green sickness.
The Cough.
1. Hollow and harking cough indicates Last stage of consumption. Chronic
bronchitis. Some nervous affections.
2. Sharp, ringing cough
3. Hoarse cough
4. Wheezing cough
5. Belching cough
6. Cough in paroxysms
7. Cough sounding harsh and concen-
trated when listening with the
stethoscope.
8. Cough sounding hollow, when lis-
tening with the stethoscope, as
thou^ it came from a cavern.
9. Cough having a metallic or ringing
sound when listening with the
stethoscope.
Croup,
Beginning of cold. Chronic laryn-
gitis.
Asthma.
Some diseases of larynx.
Hooping cough. Hysteria.
Consumption. Inflammation of the
lungs. Pleurisy. Enlargement of
bronchial tubes.
Tuberculous cavity. Enlarged bron-
chial tubes.
Large tuberculous cavity.
The Expectoration.
1 . Scanty expectoration
2. Copious expectoration
3. Watery expectoration
4. Mucous expectoration
5. Expectoration of pus
6. Expectorated matter shaped like
coin (nummular)
7. Muco-purulent, floculent expecto-
ration
8. Tubular expectoration
9. Whitish or greenish expectoration,
that clings to the vessel
10. Y'ellow expectoration
11. Rusty expectoration
12. Putrid smell of expectoration
13. Faint and sweetish smell of expec-
toration.
14. Expectoration smelling like garlic
indicates First stage of acute diseases of the
lungs.
“ Decline of acute diseases of air-passages
and lungs.
“ Beginning of bronchitis. Congestion
of lungs. Vesicular emphysema.
“ Bronchitis. Inflammation of lungs.
“ Consumption. Third stage of inflam-
mation of lungs.
“ Tubercular consumption. Bronchitis
of measles.
“ Consumption far advanced.
“ Plastic bronchitis. Pneumonia.
“ Acute affections of lungs, particularly
bronchitis
“ Chronic bronchitis. Other chronic af-
fections of the lungs and throat.
“ Inflammation of the lungs.
“ Gangrene of the lungs.
“ Bronchitis. First stage of consumption.
“ Broncho-pleural fistula.
Pain.
1. Dull, heavy, aching pain at the indicates Acute bronchitis.
base of the chest
2. Soreness about the breast bone, and “ Acute bronchitis.
between the shoulders
3. Sharp, sudden, tearing pain below “ Pleurisy.
the nipple
4. Pain darting from front part of “ Consumption.
chest to between shoulder blades
5. Constant pain between the shoulders “ Consumption. Greensickness. Other
chrome diseases.
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
137
1.
2.
3.
i.
5.
6.
7.
8.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
The Pulse.
Strong pulse, resisting compression
by the finger
Weak pulse, easily pressed down
Full pulse, as if the artery were in-
creased in size
Small pulse, opposite of full
Hard, sharp, contracted pulse, — vi-
brating like a cord under the finger
Soft pulse, 3uelding readily to pres-
sure
Frequent pulse
Slow pulse
Inflammatory affections, especially of
the substance of large organs, as the
liver, etc.
Prostration from disease. Nervous and
chronic affections. Fear. Diseases
of women and children, and old per-
sons.
Congestion of brain. Apoplexy. Dis-
ease of heart.
Inflammation of stomach, bowels,
bladder, etc. Hysteria, and other
nervous affections.
Inflammation of membranes. Active
bleedings. Lead colic, etc.
Affections characterized by debility.
Inflammatory diseases. Hemorrhages.
Apoplexy, Sometimes in disease of
heart.
indicates
Relating to Digestion.
Tongue trembling and dry, and di-
minished in size
Voracious appetite
Diminished appetite
Increased thirst
Thirst gone
Vomiting
Pain increased by pressure
Pain relieved by pressme
Urgent desire to go to stool
W atery stools
Mucous stools, like white of egg
Hard and lumpy stools
Clay-colored stools
Yellow or dark-brown stools
Dark-green stools
Stools red, and streaked with blood
Pitchy black stools
Stools pure blood, with no colic
Stools like rice-water
Black stools
Shreds of false membrane in stools
Fat with stools
Fetid stools
Typhoid and other low fevers.
Pregnancy. Hysteria. Insanity. Some-
times in dyspepsia.
In most acute diseases.
Acute affections of stomach and bowels.
Cerebral disease, with coma.
Early pregnancy. Colic. Disease of
brain. Inflammation of stomach.
Hernia.
Inflammation of internal organs.
Over-distension of bowels. Neuralgia.
Colic.
Dysentery. Sometimes in diarrhoea.
Diarrhoea. Cholera.
Chronic inflammation of colon.
Constipation. Colic. Cancer of stom-
ach.
Deficiency of bile.
Too much bile.
Bile from children after taking cal-
omel.
Dysentery.
Melaena.
Bleeding piles.
Asiatic cholera.
Iron taken in medicine.
Dysentery. Diarrhoea. Worms.
Diabetes. Consumption.
Diseases attended by debility.
indicates
ft
The Urine.
1. Diminished secretion of urine
2. Retention of urine in the bladder
3. Urine increased in amount
4. Red or yellow sand deposits in urine
(uric acid)
5. White sediment in urine (earthy
phosphates)
6. Oxalate of lime deposits in urine
7. Blood in urine
8. Albumen in urine
9. Mucus in urine
10. Sugar in urine
indicates Dropsy. Inflammatory and febrile
diseases.
“ Paralysis. Typhoid fever. Hysteria.
“ Diabetes. Cold stage of fevers. Hy-
steria. V arious passions of the mind.
“ Fevers. Acute Rheumatism. Con-
sumption. Dyspepsia. Great indul-
gence in animal food.
“ Depressed state of the nervous system,
of serious import.
“ Derangement of digestion.
“ Bleeding of kidneys, etc.
“ Bright’s disease.
“ Inflamed mucous membrane of ure-
“ thra, bladder, etc,
“ Diabetes.
138
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
The Perspiration.
1. Profuse perspiration indicates Acute rheumatism. Decline of acute
“ inflammations and fevers, being
sometimes critical.
2. Diminished perspiration
3. Night sweats
4. Sour-smelling sweat
6. Fetid smelling sweat
6. Sweat with mouldy odor
7. Smelling like ammonia
8. Sweat having the odor of mice
9. Sweat smelling like rottenstone
Early stage of acute disease. Dropsy.
Diabetes.
Consumption.
Rheumatism. Gout.
Some debilitating fevers.
Measles. Scarlet fever.
Typhoid fever sometimes.
Insanity.
Miliary.
The Temperature,
1. General heat of surface
2. External local heat
3. Hot forehead
4. Hot scalp
5. Skin of chest hot
6. Hands and feet hot.
7. Acrid heat, burning the hand when
applied
8. Chills
9. Low temperature
10. Cold hands and feet
indicates Fevers.
Inflammation.
“ Headache.
“ Disease of brain.
“ Inflammation in chest.
“ Consumption.
“ Typhus fever.
“ Beginning of fever.
“ Poor circulation.
“ Nervous diseases. Dyspepsia. Impure
state of the blood.
The Temperature of the Body.
The use of the thermometer is an important addition to the means
of making physical examination, and is one of the improvements in
modern medicine.
It is intended to measure the heat of the body.
The best kind now in use is the self-registering.
The bulb of the instrument is to be placed in the warmest part of
the body, and should be allowed to remain there for eight to ten
minutes.
Some place it under the tongue ; some in the axilla.
Sometimes it is necessary to introduce it into the rectum or vagina.
In these parts the temperature is a degree higher than in other parts.
The normal temperature of the body is from 98° to 99° Fahrenheit,
in the great majority of persons.
Exceptionally it may be half or a whole degree either above or be-
low this range.
The normal fluctuations are inconsiderable in comparison with the
variations of disease.
The natural variations in health are as follows : The temperature
is at its minimum at five o’clock A. M. ; the maximum is reached in
the latter part of the afternoon, and then decreases till five o’clock
A. M.
By means of the thermometer we are able to determine all differ-
ences with precision.
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
139
The increase of heat in different febrile diseases rarely exceeds
110° Fahrenheit, and as a rule the amount of increase is a criterion
of its severity.
An increase to 100° Fahrenheit or 101° is evidence of mildness of
the disease.
If the thermometer indicates steadily 105° Fahrenheit, it is certain
that the disease is severe.
A persisting temperature above 105° Fahrenheit denotes that there
is great danger, and an increase to 108° to 110° Fahrenheit is usually
a fatal sign.
The abnormal changes of temperature consist of more or less in-
crease.
Diminution below the normal standard is comparatively rare ; yet
it sometimes occurs and is of some importance.
In the course of typhoid fever, a sudden decrease may indicate in-
testinal hemorrhage. Sometimes the temperature falls without im-
provement in the other symptoms. This is an unfavorable symptom.
The value of thermometric changes depends in no small measure
upon the symptoms with which they are associated.
Sickness during Life.
It is estimated that 2 years’ sickness is experienced by every person
before they are 70 years old, and that 10 days per annum is the aver-
age sickness of human life. Till 40 it is half, and after 50 increases
The miscellaneous diet of man is the cause of many diseases.
Human Longevity.
Of 100,000 male and female children, in the first month of life they
are reduced to 90,506 or nearly a tenth. In the second to 88,155.
In the third to 85,976. In the fourth to 85,139. In the fifth to 84,-
122. In the sixth to 82,635, and by the end of the first year to
76,938, the deaths being 2 in 10. The next four years reduces the
76,938 to 63,048, indicating 36,952 deaths before the completion of
the fifth year.
At 25 years the 100,000 are about half, or 49,695,* at 55 about a
third; at 59 about a fourth, or about 25,000; at 67 about a fifth;
at 75, a tenth; at 80, a twentieth, or 5,000, and 10 attain 100 years.
About the age of 35 the lean man usually becomes fatter, and the
fat man leaner. Again, between the years 45 and 50 is generally a
critical time in a man’s life, his appetite fails, he becomes logy, and
tires easily upon the least exertion of body or mind. His muscles
become flabby, his spirits droop and his sleep is poor and unrefresh-
ing. After suffering under these complaints a year or two, he seems
to acquire new vigor, and goes on to 62 or 63, when a similar change
takes place, but when improvement comes he is apt to go on to a ripe
old age,
140
TEMPERAMENTS, CONSTITUTION AND SYMPTOMS.
Strength and Warmth Derived from Different
Articles of Food and Drink.
Strength derived from articles
of food and drink.
Grains of Strength yielded by
Warmth derived from one
pound of different articlesof food
Grains of Warmth yielded by
one pound of 7,000 grains.
Grains
one pound of 7,000 grains
Grains
Parsnips,
12
Whey,
151
Turnips,
13
Turnips,
238
Whey,
13
Buttermilk, ....
335
Greens,
14
Skimmed Milk, .
352
Potatoes,
24
New Milk, ....
378
Skimmed Milk,
35
Carrots,
Parsnips, ....
390
New Milk,
35
426
Buttermilk, ....
36
Potatoes, ....
770
Barley,
70
Fresh Fish, ....
980
Rice,
70
Beef Liver, ....
1,220
Bacon,
78
Red Herrings, .
1,456
Rye Bread, ....
89
Baker’s Bread, .
1,990
Baker’s Bread,
90
Fresh Beef, ....
2,300
Fresh Pork, ....
109
Molasses, ....
2,300
Corn Meal,
125
Skim Milk Cheese, .
2,355
Fresh Fish, ....
129
Seconds Flour, .
2,700
Cocoa,
130
Rye Bread, ....
2,700
Oatmeal,
140
Rice,
2,755
Mutton,
140
Barley Meal,
2,780
Fresh Beef, ....
173
Indian Meal,
2,806
Beef Liver, ....
200
Sugar,
2,900
Split Peas,
250
Fresh Pork, ....
3,100
Cheddar Cheese, .
310
Bacon,
4,201
Skim Milk Cheese .
361
Butter,
Lard, . , . . .
4,700
4,806
TEMPERAMENTS, CONSTITUTION AND SYMPTOMS.
141
The stature of the body at birth
and subsequent ages.
The additional length of life a oer-
son is expected to live after reaching
the age of years and each subse-
quent year to 70 years old.
STATURE OF MALES
STATURE OF
FEMALES
YEARS
YEARS
Age
Feet
Lbs.
Age
Feet
Lbs.
Age
Expec-
tancy
Age
Expec-
tancy
0
1.65
7.05
0
1.63
6.42
20
4U
46
24
2
2.60
25.02
2
2.55
23.53
21
40|
47
23i
4
3.05
31.38
4
3.01
28.67
22
40
48
22i
6
3.44
38.81
6
3.38
35.29
23
391
49
22
9
4.01
49.95
9
3.93
47.10
24
381
50
211
11
4.36
59.78
11
4.26
56.57
25
38
51
20i
13
4.73
75.81
13
4.61
72.65
26
37J
52
19i
15
5.08
96.40
15
4.92
89.04
27
36^
53
19
17
5.36
116.56
17
5.10
104.34
28
35|
54
m
18
5.44
127.60
18
5.15
112.55
29
35
55
17f
20
5.50
132.46
20
5.16
115.30
30
34|
56
17
30
5.52
140.38
30
5.18
119.82
31
33f
57
16|
40
5.52
140.43
40
5.18
121.81
32
33
58
15i
50
5.50
139.96
50
5.05
123.86
33
321
59
15
60
5.38
136.08
60
4.98
119.76
34
31|
60
14i
70
5.32
131.28
70
4.97
113.60
35
31
61
14
80
5.29
127.55
80
4.95
108.80
36
30^
62
13h
90
5.28
127.54
90
4.94
108.81
37
29 1
63
13
38
29
64
12^
39
28i
65
111
40
27|
66
m
41
27
67
10|
42
26i
68
lOi
43
25|
69
9|
44
25i
70
9|
45
24^
Weight of the Human Body.
The weight of the male at birth is 7 lbs., that of the female is
about lbs. The maximum weight (140^ lbs.) of the male is at-
tained at 40; that of the female (nearly 124 lbs.) is attained at 50.
The full grown adult is 20 times as heavy as a new-born infant. In
the first year he triples his weight. At an equality of age the male
is heavier than the female. Towards the age of 12 years only, an
individual of each sex has the same weight.
Children lose weight the first three days after birth; at the age of
a week their weight gradually increases; after 1 year they triple in
weight and require 6 years to double their weight, and 13 to quad-
ruple it.
SYMPTOMS
That quickly tell what your complaint is.
Backache.
Leucorrhea. Whites. — Discharge from the vagina (catarrh)
slight or profuse; thin, glairy; thick, lumpy or stringy; watery or
milky; yellowish, greenish, bloody or purulent; odorless or offensive;
bland or excoriating, with heat, burning and itching of genitals;
headache; dizziness; backache; indigestion.
Displacement of the Uterus. — Weight in lower abdomen; pressing
and bearing down sensations; disturbances of menstruation; back-
ache.
Bowels,
Hernia. Rupture. — May be protrusion of intestines in groin,
which can be pushed back; or strangulated, when not reducible,
with inflammation, pain, nausea, vomiting, constipation, cold sweat,
anxiety, gangrene.
Colic, Intestinal. — Paroxysms of severe, twisting or boring pain,
centering about navel, radiating through abdomen, better from
friction and pressure; abdomen usually distended; may be cold
sweat, feeble pulse, and vomiting.
Inflammation of the Bowels.— Colicky pains in the bowels; diar-
rhoea, with thin, liquid stools containing undigested food and mucus,
sometimes blood-streaked; tenderness; high fever; rapid pulse; pa-
tient lies on back, with legs drawn up.
Peritonitis, Acute. — Sudden onset, with chill; sharp, and cutting
pains in abdomen, with great tenderness; distention of bowels with
gas; high fever; hiccough; nausea, vomiting, and constipation; pa-
tient lies on back with knees drawn up; pulse small, rapid, "wiry.”
Dysentery. — Constant desire to evacuate the bowels, with much
straining, and never-get-done feeling; small stools containing mucus
and blood; pain; tenderness; prostration.
Cholera Morbus. — Cramps in the stomach and abdomen; vomiting
and purging of bilious matter; frequent and copious evacuations;
thirst; moderate fever; headache; great prostration; coldness of ex-
tremities.
142
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 143
Cholera Infantum. — Vomiting and pm’ging; thin, watery, musty
smelling stools; intense thirst; great restlessness; hollow eyes;
pinched, pale face; rapid, feeble pulse; rapid emaciation; great
exhaustion.
Chills.
Influenza. La Grippe. — Abrupt onset; great prostration; chil-
liness; stiffness, bruised pain in muscles of neck, back and legs; severe
pain in head; sneezing, hoarseness and paroxysmal hard cough;
running from nose; breathing difficult; or acute nervous symptoms
with sleeplessness, intolerable pain in head, delirium, meningitis
or severe gastric disturbance or symptoms as in typhoid fever.
Bronchitis, Acute. — Chilliness; debility; soreness and constric-
tion behind breast bone; slight fever; irritative, dry, painful cough
becoming loose, with partly mucous, partly purulent expectoration;
difficult breathing.
Mumps. — Chilliness; debility; moderate fever; pain in angle of
the jaw; doughy swelling of parotid gland; often swelling of other
glands under one or both sides of jaw, and in throat; increase of
sahva; may be sympathetic swelling of breasts or testicles.
Bright’s Disease, Acute.— Chill followed by fever; nausea; face
puffy; extremities swollen and dropsical; dull pain over kidneys,
extending downward; frequent urination; quantity of urine dimin-
ished; urine smoky, reddish, turbid and contains albumen.
Bright’s Disease, Chronic. — Slower development of symptoms as
in acute form; general debility; headache; indigestion; lassitude;
nausea; drowsiness; much swelling and dropsy.
Cough.
Bronchitis, Chronic. Winter Cough. — Persistent cough, with more
or less partly mucous, partly purulent expectoration; soreness be-
hind breast bone; shortness of breath; oppression; rales in chest.
Croup, False Membranous. — Peculiar ringing cough, becoming
muffled; hoarseness and difficult breathing continue after a spasm
passes; false membrane is coughed up; great restlessness and agita-
tion; clutching at the throat.
Whooping Cough. — In the beginning, slight fever, sneezing, run-
ning from the nose, dry cough; in one or two weeks cough more
violent and in hard paroxysms, with eyes congested, face bluish,
veins disturbed, often vomiting, may be nosebleed, long drawn,
shrill whoop at end of paroxysm.
Asthma. — Sudden attacks generally at night; great oppression
in chest; distressed breathing, cannot “catch his breath;” profuse
perspiration; face pale and anxious; cough and expectoration of
thick, tenacious mucus; loud wheezing in chest.
144
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
Constipation.
Prolapsus Ani. — Descent or protrusion of mucous membrane of
lower bowel through the anus; irritation; constipation; straining at
stool.
Piles. — Veins of rectum distended in little lumps; may protrude,
bleed, itch, be sore, cause or aggravate constipation.
Depression.
Hydrophobia. — Anxiety; depression; restlessness; pain in wound;
slight fever; increasing difficulty in swallowing; spasm of muscles of
neck, especially at sight of water; salivation; convulsions; delirium;
exhaustion; suffocation; heart failure.
Opium Poisoning, Chronic. — Loss of flesh and strength; trembling;
debility; sallow complexion; loss of appetite; disturbed sleep; men-
tal depression; irritability; tendency to lie and deceive; irresistible
craving for the drug.
Eyelids.
stye, — Small, painful boil on eyelid, with heat, redness, swelling,
and rapid suppuration.
Tracoma. — Inflammation and thickening of the lining mem-
brane of the eyelids, with formation of granulations on inner side
of lids.
Ear.
Inflammation of Middle Ear. Otitis Media. — Inflammation;
pain; swelling of the drum and lining membrane of middle ear; watery
discharge; with suppurating form, acute pain; ringing in ear; deaf-
ness; fever; formation of pus; bulging of drum which may rupture.
Fever.
Chicken Pox. — Fever; chilliness; sparse, superflcial eruption ol
crop of pimples, most abundant on the trunk, drying up in two or
three days, with depressed, blackish crust in centre.
Fever and Ague. — Debility; nausea; vertigo; shivering, increase
ing to severe chill, with chattering of teeth; “goose skin”; hurried
shallow breathing; small, rapid pulse. Chill, followed by fever,
with face flushed; eyes red; pulse full and rapid; pain in back and
limbs; intense thirst; urine scanty. Hot stage followed by free
perspiration; decline of fever; increase of urine.
Scarlet Fever. — ^Vomiting or convulsions; may be a chill; high
fever; rapid pulse; heavily coated, then bright red, swollen tongue;
throat red, sore; swallowing painful; glands enlarged; great thirst;
TEMPEEAMENTS, CONSTITUTION, AND SYMPTOMS. 145
scanty urine; fine, diffuse, red rash first on neck and chest; lasting
five to seven days, and disappearing momentarily on pressure; erup-
tion leaves branny scales; great restlessness, sleeplessness, headache,
often convulsions.
Typhoid Fever. — Gradual onset with headache, debility, vague
pains, nosebleed, may be slight diarrhoea, loss of appetite, then gradual
rise of temperature, lower mornings, higher evenings; abdomen swollen
and tender ; with rose-colored spots on abdomen seventh to ninth day ;
spots disappear on pressure; gurgling in abdomen; pea soup diar
rhoea; tongue becomes dry, brown; teeth and lips covered with sticky
deposit; delirium or stupor; bleeding from bowels; picking at bed
clothes.
k: Typhus Fever. — Sudden pain in head, back and legs; extreme
prostration; fever reaching 104 to 105° in from two to three days,
and remaining high about two weeks; rapid, weak pulse; musty odor ;
face livid and dull; pupils of eyes contracted; coarse, mulberry
rash fourth or fifth day on trunk and extremities; urine scanty;
marked nervous symptoms; bowels constipated.
Yellow Fever. — Chill, pain in head, back and limbs; rapidly ris-
ing fever; vomiting; thirst; constipation; then remission of symp-
toms for six hours, followed by their acute return; jaundice of skin;
black vomit; bleeding from mouth, bladder, etc. ; scanty or suppressed
urine; great prostration; collapse and death or slow convalescence.
Smallpox. — Chill or series of chills, followed by vomiting and
intense pain in small of back; rapidly increasing fever, falling the
third or fourth day; rising again seventh or eighth day; pulse full,
rapid; skin dry; breathing hurried; red spots first on forehead,
face and wrists having hard, shot-like feel; skin between is swollen;
soft, yellow, offensive crusts; spots may run together or black and
blue spots form.
Rheumatic Fever. — Sudden reddening, swelling and tenderness
of one of the large joints, with intense pain; sudden shifting of symp-
toms to another joint; moderately high fever; rapid, bounding
pulse; scanty urine; no appetite; constipation; heavily coated
tongue.
Cholera, Asiatic. — ^Vomiting alternating with painless diarrhoea;
frequent, sudden rice-water movements from bowels; excruciating
cramps in calves of legs, thighs, arms, and abdomen; face pinched,
blue, sunken; cold, clammy sweat; pulse thready, weak; breath cool;
voice husky; collapse and stupor.
Inflammation of 5pinal Cord, Acute. — Moderate fever; loss of
appetite; coated tongue; constipation; followed by radiating pains
from back to limbs, with numbness, tingling or burning; pain about
waist; loss of motion of limbs and increasing paralysis.
146
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
Spotted Fever. Epidemic Cerebrospinal Meningitis. — Sudden on-
set; chill followed by fever; nausea; great thirst; vomiting; severe,
continuous headaches; painful stiffness and retraction of muscles
of the neck; dusky mottling of the skin.
Measles. — Sneezing; hoarseness; cough; running from eyes and
nose; eyes red and sensitive to light; moderate fever; eruption of
small pale or dark red velvety spots on face, then on trunk and
extremities, with itching and burning; eruption lasts four days to
a week.
Heart.
Weak Heart. — Palpitation, with feeling of oppression about chest;
fluttering, irregular pulse; headache; dizziness; bloodlessness; de-
bility; indigestion.
Enlargement of the Heart. Hypertrophy. — When excessive there
may be weight and discomfort in the chest; bulging of chest wall;
a heaving impulse of heart against chest; shortness of breath; head-
ache; vertigo; ringing in the ears; paroxysmal cough; palpitation;
indigestion; sleeplessness.
Neuralgia of the Heart. Angina Pectoris. — Sudden attacks of
excruciating pain in the heart, with horrible sense of suffocation;
face pale and cold; pulse variable, often weak and irregular; pain
in left shoulder; attack passes off with belching of gas.
Inflammation of the Heart. — Pain in region of the heart, sense
of oppression; anxiety; difficult breathing; fever; slight cough; head-
ache; vertigo; may be nausea; irregular action of heart; palpitation.
Headache.
Chlorosis. Green Sickness. — Impoverished blood at puberty;
greenish pallor of skin; oalpitation; indigestion; nosebleed; irri-
tability; appetite for chalk, slate pencils, etc. : debility.
Brain Fever. — Intense headache ; vertigo; intolerance to light and
sound; restlessness; heat in head; eyes bloodshot ; fever; later, drow-
siness and inclination to vomit; convulsions in children; rapid, feeble
pulse.
Insensibility.
Epilepsy. — Peculiar, premonitory sensation beginning in finger
or toe, followed by sharp cry, and sudden fall to the floor, with partial
or complete loss of consciousness, frothing at mouth; biting of the
tongue; clenching of fingers; face becomes bluish; pupils dilated;
stupor for a varying period follows, or immediate consciousness
with soreness, weakness and mental confusion.
Hysteria. — Convulsive seizures simulating epilepsy, but patient
generally fa, Us in a comfortable place; is only apparently unconscious;
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 147
screams, cries, or laughs; urine often retained; sensation of ball in
the throat; headache as of nail in the head; may be partial paralysis,
or legs and arms thrown wildly about.
Apoplexy. — Patient suddenly falls unconscious; face flushed;
breathing labored; pulse full and slow; paralysis on one side; tongue
protruded; may be convulsions, and involuntary passage of urine
and feces.
Catalepsy. Trance. — Patient apparently insensible; lies quiet;
limbs remain in any position they are placed; muscles stiff and
unyielding.
Sunstroke. — Weakness, dizziness and faintness after exposure
to heat, or partial or complete unconsciousness; pallor of face; cold
sweat; shallow, hurried breathing; or dry, burning skin; face and
eyes congested; pulse full and rapid; pupils contracted; stupor; a
dangerous form.
Paralysis. — Attack preceded by numbness, coldness, paleness,
and slight convulsive jerking or twitching, followed by loss of motion
partial or complete, and of upper or lower half of body, or one or
both sides; may be loss of speech and other faculties.
Lungs.
Bleeding from the Lungs. — May be preceded by cough, difficult
breathing, warmth or tenderness in chest, salty taste in mouth;
blood may gush up or be coughed up, vdll be bright red, fluid, and
frothy, and taste sweetish or salty.
Pneumonia. Lung Fever. — Sudden hard chill and sharp pain
in the’ side, with sharp rise of temperature, generally falling suddenly
to normal the fifth, seventh or ninth day; shallow, very rapid, diffi-
cult breathing; short, dry, hard cough, later with blood-streaked,
rusty expectoration, becoming free and like prune juice; pain in chest;
no appetite; tongue coated; thirst, scanty urine; congestion and
consolidation of lungs; may be typhoid symptoms.
Consumption. Pulmonary Tuberculosis. — Fatigue and short breath
on slight exertion; loss of appetite; imperfect digestion; paleness,
with hectic flush over cheek bones; irregular fever; hacking cough,
at first dry, later with increasing expectoration; night sweats;
loss of weight; bleeding from lungs; may be diarrhoea; tubercle
bacillus in expectoration; contraction of chest; swelling of feet.
Nose.
Hay Fever. — Great susceptibility to pollen of rag weed, hay,
roses, etc.; redness of eyes, swelling of eyelids; sneezing; running
from eyes and nose; obstruction of nose; headache; cough; may
be asthma.
148 TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
Catarrh, Chronic Nasal. — Mucous or partly mucous, partly puru-
lent discharge from nose, obstruction of nostrils; mouth breathing;
nasal voice; headache in forehead; dropping of secretions into
throat; frequent hawking; may be deafness and loss of taste or
smell.
Pain.
Inflammation of the Liver. — Drawing sensation on the right side
in region of the liver; slight chill; fever; headache; indigestion;
loss of appetite; may be nausea and vomiting; slight jaundice; scant
urine; sometimes hiccough; weakness; loss of flesh.
Lockjaw. Tetanus. — Painful, increasing stiffness of the head,
neck, and pain extending to back, abdomen and extremities; corners
of mouth drawn upward; jaws tightly closed; body convulsively
arched or rigidly straight; slightest touch causes spasm with great
pain.
Pleurisy. — Sharp, stabbing pain in the side, worse on deep breath-
ing and motion; breathing feeble, shallow and rapid; slight, irrita-
tive cough; scanty, frothy expectoration; may be effusion of fluid
into covering of lungs, with chills, fever, sweats and emaciation.
Gout. — Restlessness; wakefulness; irritability; dyspepsia; scanty,
high-colored urine; agonizing pain and tenderness in ball of great
toe; toe reddish purple and glazed; veins enlarged; in chronic gout
joints enlarged, deformed, chalky, stiff, may ulcerate.
Gall Stone Colic. — Passage of gall stones causes sudden, agonizing,
cutting, tearing or shooting pain on the right side of abdomen, spread-
ing to right side of chest and shoulder; muscles of abdomen cramped
and tender; nausea; vomiting; profuse sweat; frequent urination;
pale, distorted, anxious face ; feeble pulses.
Painter’s Colic. — Violent, painful contractions of the abdominal
muscles; hollowing in of the abdomen; obstinate constipation; grip-
ing, cutting pains; may be blue line around the gums.
White Swelling. Tubercular Arthritis. — Dull pain in joints,
worse by motion or jarring; tenderness on pressure; more or less
swelling and exudation of fluid ; wasting of muscles above and below ;
skin white and shiny.
Sciatica. — Sharp, shooting pain running down the back of thigh;
worse from motion; may be tingling and numbness, and nerves sensi-
tive to touch; worse at night and in stormy weather.
Stone in the Kidneys. — Constant dull pain in the loin; on passage
of stone, excruciating paroxysm of pain radiating into groin and
bladder; numbness of thigh; nausea; vomiting; sweat; rapid pulse;
sufferer may faint.
TEMPEK AMENTS, CONSTITUTION, AND SYMPTOMS. 149
Inflammation of the Testicles. Orchitis. — Drawing, stretching
pains from abdomen through spermatic cords and testicles; testicles
swollen, sensitive, with soreness and tearing pains; drawing up of
testicles, burning and difficulty in urinating.
Writer’s Cramp. — Fatigue, weight or actual pain in muscles of
hand; spasm of muscles when fingers grasp a pen; hand may tremble
or neuralgic pain occur.
Hip Joint Disease. — Slight lameness; stiffness of muscles about
the joint; progressive wasting of muscles of thigh; limping, with
shortening of leg; more or less fluid in joint, and restriction of motion;
formation of abscess, with pain and tenderness; deformity of hip.
Poisoning.
Arsenic Poisoning. — Burning in stomach and bowels; cramps in
abdomen and legs; vomiting followed by diarrhoea; rice-water stools
which are bloody.
Lead Poisoning. — Obstinate constipation; abdominal colic; wrist
drop; blue line about the gums; cramps in the legs; pains in the
joints; trembling of extremities; intense headache; may be convul-
sions, delirium and lethargy.
Skin.
Eczema. Salt Rheum. — Inflammation of skin, with watery pimples
or pustules forming scales and crusts; itching; burning; watery or
yellow sticky discharge, or oozing; raw surface beneath crusts; or
dry, scaly patches, without itching.
Itch. Scabies. — ^Small pimples first appearing between fingers,
in creases of wrists, groin, armpit, under the breasts, on inner side
of thighs, with intense itching.
Ringworm of the 5calp. — Small, separate, round or irregularly
shaped, reddened scaly patches, turning to little vesicles filled with
matter, which dry up and scale off; hair dead and brittle; patches
spread rapidly.
Shingles. Herpes Zoster. — Pin head to pea-sized watery pimples
along a nerve, preceded, accompanied or followed by neuralgic pains
in affected part; one side of body only; fluid dries up, and yellow-
brown crusts form and drop off.
Nettle Rash. Urticaria. — Skin shows pale red elevations, itching
intensely; finger drawn over surface causes white line which becomes
elevated and red; eruption on covered parts of body especially.
Boil. — Small, limited, painful tumor beginning as a sore, itching
pimple, developing a core of dead tissue, and suppurating.
150 TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
Carbuncle. — Dark red, painful, circumscribed, flattened swelling,
surrounded by dusky-red skin, appearing on neck, back or buttocks,
suppurating in a week or ten days, and discharging through several
openings.
Cancer of the Skin. Epithelioma. — In the beginning a few greasy
scales or papery crust covering three or four shallow irregular ulcers
with hard margin; or may be deep-seated, shiny, hard, red lump,
changing to ulcer with blood-stained yellow fluid, or offensive sticky
discharge; sharp, shooting pains.
Blackheads. Acne. — Small pimples on face, chest, shoulders,
back, neck; moist or dry; reddish or black; with or without indiges-
tion, debility, menstrual disorders; may contain matter or cheesy
substance.
Warts. — Pinhead to bean-sized, limited elevation of the skin;
some soft, red, dry or moist; bleed easily; some soft and pearly;
others hard, black, flat or rounded.
Gangrene. Mortification. — In dry form, skin pale, dry, shriveled,
semi-translucent, with bluish-mottled specks becoming dark, opaque,
mummified; in moist form, congestion of part; skin dark, livid,
moist; tissues soften and break down; foul odor.
Ulcers. — Sore on leg or elsewhere, red, inflamed, irritable, with
painful, ragged edge; or varicose ulcer with much distention of nearby
veins; or syphilitic ulcer with punched-out looking sore, and offen-
sive discharge.
Milk Crust. — Small pimples form on face or scalp of infants and
children, with redness and itching; pimples rupture and exude a
sticky fluid forming yellow crust, with raw surface underneath.
Scurvy.— Great debility; bloodlessness; spongy, bleeding gums,
with foul breath; teeth loosened; pain in legs; skin dry and rough;
flesh brawny and hard; complexion shallow; bleeding from mouth,
bladder, etc.; short breath; feeble pulse.
Erysipelas. — Slight fever, chilliness, tingling of affected part,
which becomes glossy, bright red or brawny, swollen, hard, sharply
defined; fever increases; pulse full, rapid; appetite lost; bowels con-
stipated; tongue coated; small pimples form; inflammation spreads
or begins to subside in four or five days.
Swelling.
Scrofula. — Swelling and suppuration of glands of neck, groin
and under the arms; sometimes slight fever, debility, emaciation;
free perspiration, especially about the head.
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 151
Goitre. — Usually non-painful, non-tender swelling of varying
size of thyroid gland in neck; when large, causing difficult breathing,
headache, flushed face; may be shooting pains.
Dropsy. — Swelling of feet, hands, legs, abdomen or chest in lung,
liver, kidney or heart disease; swelling and paleness of skin; sur-
face hard and pitting on pressure of finger.
Goitre, Exophthalmic. — Debility and bloodlessness; enlargement
of thyroid gland; protrusion and staring appearance of eyes; palpi-
tation; pulse beats 100° to 140° a minute; blowing sound over gland.
Stomach.
Dyspepsia, Nervous. — Tongue often clean, appetite very variable,
may crave acids, slate pencils, etc.; headache; vertigo; irritability;
depression; sleeplessness or bad dreams; lassitude; palpitation;
lump in the chest.
Dyspepsia, Catarrhal. — Loss of appetite; sense of fullness and
discomfort; eructations; nausea and sometimes vomiting; tongue
heavily coated; mucus in vomitus and stools; may be diarrhoea;
hiccough; heartburn.
Bleeding from the Stomach. — Usually occurs with vomiting and
is provoked by taking food; blood is dark, clotted, and generally mixed
with contents of stomach.
Neuralgia of the Stomach. — Intense, griping, agonizing pain in
stomach usually extending to the back, with belching of gas, faint-
ness, and intermittent pulse; symptoms partially relieved by pres-
sure over stomach.
Cancer of the Stomach. — Indigestion; great acidity; flatulence;
loss of appetite; foul breath; great debility; emaciation; vomit-
ing; coffee-ground vomit from retained blood; pain, more or less
continuous.
Colic in Infants. — Sudden paroxysms of spasmodic crying often
waking child from sleep; jerking of the feet; clenching of the hands;
sudden drawing up, then straightening of the legs; flatulence; dis-
tention or retraction of the abdomen; contortions of whole body.
Sores.
Syphilis. First Stage. — Within a month of exposure, small, red
sore appears on genitals, which enlarges and breaks in centre, leaving
ulcer; nearby glands enlarge and become hard; may be no impair-
ment of general health.
Syphilis. Second Stage. — Within six' or eight weeks, sore throat;
moderate fever; languor; headache; bone pains; indigestion; ulcers
152
TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.
on throat or tonsils; dull copper-hued eruption on abdomen, chest,
arms, shoulders, genitals.
Syphilis. Third Stage. — Within one or many years, pustules on
body which form deep ulcers, with dry crusts and scales; loathsome
sores leaving bad scars; ulceration of throat, palate, nose; hard
lumps in muscles and under skin.
Abscess. — Localized inflammation, with heat, swelling, pain,
formation of pus, tendency to point and discharge matter.
Throat.
Tonsilitis. — Tonsils swollen; difficulty in swallowing and much
pain; often cheesy spots or patches on tonsils and throat; dribbling
of saliva; fever; headache.
Enlarged Tonsils. — Tonsils too large; may contain minute cavi-
ties containing foul, cheesy matter; mouth breathing, difficult swal-
lowing; snoring during sleep; mental dullness; night terrors; deaf-
ness; bad breath; thick voice.
Quinsy.— Tonsilitis symptoms, together with inflammation of
deeper tissues; chills; high fever; swelling of glands of neck; sup-
puration, and formation of tonsilar abscess, with tendency to point
and discharge.
Croup, Spasmodic. — Hoarseness and slight cough during day;
sudden awakening at night by severe paroxysm of suffocative,
hard, barking cough; skin hot; pulse tense and rapid; perspiration.
Pharyngitis. — Soreness of back of mouth and throat; pain on
swallowing or difficult swallowing; coating of glairy mucus on roof of
mouth, tonsils and throat; some fever; swelling of affected parts.
Diphtheria. — Chills, moderate fever, sore throat, indisposition,
followed by stiffness and swelling of glands of neck; grayish white
membrane in throat, removal of which causes bleeding; weak pulse,
scanty urine; detection of Klebs-Loffler bacillus.
Thrush. — Swollen, red, spongy gums; flaky, white deposits of
lining membrane of mouth, leaving bleeding spots when removed;
fever; pain in mouth; mouth waters; bad breath.
Urine.
Incontinence of Urine. Enuresis. — Profuse involuntary flow of
pale, watery urine; constant dribbling of urine while sitting or walk-
ing; dribbling of scanty, high colored urine; wetting the bed at
night.
TEMPfiRAMlfiN'TS, CONSTITUTION, AND SYMPTOMS 153
Retention of Urine. Strangury. — Urine passed drop by drop, with
much urging and straining; pain and heat along the urethra: diffi-
cult, scanty urination.
Stone in the Bladder. — Irritation and inflammation of bladder;
frequent burning discharge of small amounts of urine, with urging;
acute pain on passage of stone, with bloody urine; sudden stoppage
of stream of’ urine.
Inflammation of the Bladder. Cystitis. — May begin with chilliness
and fever, then constant dull ache, or sharp agonizing pain in bladder ;
frequent lU’ging to urinate, with burning pain on urinating; pus in
the urine.
Diabetes Mellitus. — Gradual failure of health; frequent and ex-
cessive urination of pale urine, loaded with sugar; great thirst and
emaciation; large appetite; constipation or exhausting diarrhoea;
skin, mouth and throat dry; itching of skin; teeth decay; failure of
sexual powers.
Jaundice. — Yellowishness of the skin, white of eyes, inside of
mouth and of urine and feces; stools light colored; urine dark; may
be itching of the skin; mental depression; delirium, convulsions,
and stupor in bad cases.
Inflammation of Urethra. Gonorrhea. — Burning heat, tenderness
and puffiness at entrance of urethra; catarrhal discharge, soon turn-
ing to thick, purulent matter; frequent, painful erections; urine
passed in spurts, drops or twisted stream.
Dropsy of the Abdomen. — Sensation of weight in the abdomen;
distention; difficult breathing; scanty urine; swelling of the feet;
constipation; fluctuation of fluid on pressure.
Worms.
Worms. — Loss of appetite or ravenous hunger; disturbed sleep;
great restlessness; picking at the nose; bad breath; lassitude; dark
circles round eyes, indigestion; straining at stool; itching of anus;
grinding of teeth in sleep; may be colicky pains.
Tape Worm. — May be no symptoms, or may be indigestion;
mucous stools; colicky pains; voracious appetite; debility; night ter-
rors; intense itching of nose and genitals; twitching of muscles;
convulsions.
SKIN DISEASES
The Skin Magnified
1. Pores of Skin. 2. Outer layer of Skin or Cuticle. 3. Dermis or upper layer of true Skin.
4. Under layer of true Skin. 5. Nerve Prolongations. 6. Blood Vessels. 7. Sweat glands sur-
rounded by cells of fat. 8. Glands or cells of fat.
Skin of the back of the hand showing pores,
glands and hair (magnified) .
Skin of the palm of the hand magnified 1000
times, showing pores through v^hich sweat
passes.
156
SKIir DISEASES.
Such as are distinguished by inflammation of the derma, without
constitutional symptoms of a specific hind.
Congestive Inflammation of the True Skin.
The First of these Groups, — those characterized by inflammation
of the cutis, with constitutional symptoms of a specific hind, — embraces
measles, scarlet fever, varioloid, and cow-pox.
Measles. — Rubeola.
Measles is an acute inflammation of the entire skin, both external
and internal, associated with an infectious and contagious fever.
Symptoms. — The disease sets in with chills, succeeded by burning
heat, listlessness, languor, drowsiness ; pains in the head, back, and
limbs ; frequent pulse ; soreness of the throat ; thirst, nausea, vomit-
ing, frequent dry cough and high-colored urine. These symptoms
increase in violence for four days. On the third day the eyes become
inflamed, cannot bear the light, and pour fourth a profusion of tears.
This last symptom is called coryza. The nose likewise discharges a
large quantity of watery secretion, and sneezing is frequent. The
larynx, windpipe, and bronchial tubes become inflamed, and hoarse-
ness, soreness of the breast, etc., are the result.
The redness of the skin and breaking out appear about the fourth
day, and produce heat and itching. This breaking out is character-
ized by a patchy redness, wliich, on close inspection, is found to con-
sist of numberless minute red points and pimples, collected into
patches in the shape of a half or quarter moon. They appear first on
the forehead and front of the neck, then upon the cheeks and around
the nose and mouth. On the fifth day they reach their height in this
region, and then appear upon the body and arms, and on the sixth
day, upon the legs. The color of the skin, when the inflammation is
at its height, is of a bright raspberry red. The decline of the rash
takes place in the same order in which it comes out. The redness
fades on the sixth day upon the face ; on the seventh, upon the body
and limbs ; on the eighth, upon the back of the hands. The coryza,
the hoarseness, and the cough, decline about the seventh day, while
a diarrhoea comes on about the eighth or tenth, — showing that the in-
flammation of the mucous membrane is subsiding. When the inflam-
mation disappears, the whole scarf-skin peels off in the form of a
scaly scurf. The artist has given a good picture of the disease in the
beautifully colored lithograph, Plate I, Fig. 1.
Treatment. — When the disease is mild and regular in its course,
scarcely anything will be required, except mild diet, slightly acid
drinks, with flax-seed tea, slippery elm, or some equivalent, to quiet
the cough. Sponging with tepid water, if done with frequency, mod-
erates the fever, and adds to the comfort of the patient. If the fever
'4-'
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SKIN DISEASES.
157
runs high, take half an ounce of rochelle salt, and use recipe 125.
Should the eruption “ strike in,” apply leeches or cups over the in-
ternal organ affected, if any, and recall the rash by sweating.
Those who have been exposed to the contagion, and are liable to
have the disease, should avoid all unnecessary exposure to wet or
cold, — keeping the feet warm and dry, and the whole body well clad.
With these precautions, and a mild, unstimulating diet, much of the
force of the disease may be broken.
During the first stages of the disease if the onset has not been
stormy nothing further will be necessary than the precautions already
advised. Should, however, the rash be delayed or appear in patches
over the body, the patient should be given a full bath of either hot
water or hot water with the addition of mustard in the proportion of
two teaspoonfuls to the gallon. The employment of hot drinks should
be limited to saffron tea or hot lemonade, as we use care not to add
to the existing high fever which usually is present when the eruption
is slow in appearing.
Besides the milder forms of the disease, cases occur, chiefly in
broken-down constitutions, in which the rash delays its coming out
till the seventh day, and is then mingled with dark and livid spots,
which remain, often, for ten or twelve days. The fever is of a low,
typhoid kind, and the patient is extremely weak and languid.
In this condition of things, the patient must be supported by tonics
(77 and 59), and whisky, and expectoration promoted by some appro-
priate remedy, if required.
If at any stage of the disease there should be fixed pain in any
part of the chest, which is made worse by coughing, or by taking a
full breath, we may conclude there is some inflammation of the
chest.
The seriousness of this complication will be understood from the
fact that the bronchitis has now extended and small patches of in-
flammation known as broncho-pneumonia have appeared. Medicines
to enable the patient to raise the phlegm easier, such as five grains of
chloride of ammonia in two tablespoonfuls of sweetened water or
simple syrup may be given every three hours, and 1-80 of a grain of
sulphate of strychnia to support the heart, in addition to the other
treatment given under the heading '‘broncho-pneumonia.”
Scarlet Fever. — Scarlatina.
This is likewise an acute inflammation of the entire covering of
the body, both external and internal, connected with fever which is
infectious and contagious.
Symptoms. — The fever comes on somewhere between the second
and tenth day after exposure. On the second day of the fever, the
eruption comes out in the form of very small points and pimples,
which appear either in patches, or constitute a general redness, of a
hrigJit scarlet color. In Plate I, Fig. 2, the artist has given a fine
picture of the disease.
158
SKIN- DISEASES.
The disease begins with languor, pains in the head, back, and limbs,
with drowsiness, nausea, and chills ; and these are followed by heat,
thirst, etc. When the redness appears, the pulse is quick, and the
patient is anxious, restless, and sometimes delirious. The eyes are
red, the face swollen, the tongue covered in the middle with white
mucus, and is studded with elevated points of extreme redness. The
tonsils are swelled, and the throat red. The greatest degree of red-
ness is reached on the evening of the third or fourth day from its be-
ginning, when a gentle moisture appears, the disease begins to decline,
with itching, and the scarf-skin falls off in branny scales.
A swelling or puffiness of the flesh, which spreads out the Angers
in a singular manner, seems to be peculiar to scarlet fever.
In the first stage of the complaint, the tongue, as stated above, is
covered with a fur ; but as it advances, the tongue often becomes
suddenly clean, and presents a glossy, fiery-red surface, which is
sometimes, with the whole lining of the mouth, raw and tender.
It is peculiar in this complaint, that the inflammation of the
throat always runs into a state of ulceration. As far as can be
seen, on pressing down the tongue, the throat is swollen and of a
deep, florid red; and on the tonsils may be seen white or gray
ulcers. This makes swallowing very difficult, and aggravates the
sufferings of the patient. The great amount of mucus in these
parts causes also a continual rattling in the throat.
In quite a large number of cases of this disease the usual ulceration
of the throat is replaced by an attack of true diphtheria, which, if
at all severe, will require the giving of antitoxin of diphtheria in
addition to the treatment recommended for scarlet fever.
The eustachian tube, which extends up to the ear, is apt to get
involved in the inflammation, and cause swelling and pain in that
region. The glands under the ear and jaw
sometimes inflame, and after a time they oc-
casionally break. Abscesses formed in the
ear frequently produce some deafness which
is not easily cured.
In the cell-dropsy, which sometimes appears
after scarlet fever, the crystals of urate of
ammonia may often be found in the urine
with the microscope (Fig. 72).
This disease resembes measles, but may
Fig. 72. be distinguished from it by the absence of
cough ; by the eruption being finer ^ and of a more scarlet color (see
plate) ; by the rash coming out on the second day instead of the
fourth ; and by the ulceration in the throat.
Treatment. — In ordinary cases, the treatment should be very
simple. The apartment should be kept cool, and the bed-covering
light. The whole body should he sponged with cool water as often as
it is hot and dry, and the patient be permitted to take cooling drinks.
Besides this, in many cases, very little is needed, except to give a
few drops of the tincture of belladonna, night and morning.
SKIK DISEASES.
159
The cold stage having passed, and the fever set in, warm water
may be used without the mustard, etc. If the head be affected, put
mustard drafts upon the feet. Should the bowels be costive, they
may be gently opened by some very mild physic.
No solid food should be allowed ; but after the first shock of the
disease is passed, drinks, in reasonable quantities, will be advisable, —
such as cold water, lemonade, barberry and tamarind water, rice
water, balm or flax-seed tea, and some thin water-gruel.
To promote the action of the skin, the spirits of nitre, with other
articles (125), adapting the dose to a child, will be found useful.
Muriatic acid, forty-five drops in a tumbler filled with water, and
sweetened, and given to a child in teaspoonful doses, is a good remedy.
In very violent attacks, the system sometimes inclines to sink im-
mediately ; typhoid symptoms show themselves ; there is great pros-
tration ; the eruption strikes in ; the skin changes to a purple or
mahogany color ; the tongue is of a deep red, or has a dark-brown
fur upon it, and the ulcers in the throat become putrid. This is
called scarlatina maligna ; but it is only a severer form of the same
disease. .
The treatment of this form must be different from that recom-
mended above. It must be tonic. Quinia (65) must be freely given.
Wine whey, mixed with toast-water, will be useful. Tincture of
cayenne, in sweetened water, may be given often in small doses.
Ammonia (135) may likewise be given as a stimulus. Gargles (245)
(244) (243) are also required.
A dropsical affection is one of the most frequent results of scarlet
fever. It is believed that this seldom occurs, if the warm bath is
daily used, as soon as the skin begins to peel off. After the dropsy
has set in, give the warm bath twice a week, and encourage perspi-
ration by the compound tincture of Virginia snake-root, and similar
articles.
In young children, also in severe cases of fever or where the kidneys
are not working properly as shown by swelling of the face, abdomen
and extremities, milk should be the only article of diet allowed until
these symptoms have quieted down. Should the stomach reject the
milk, you may add lime water, a teaspoonful to a tumbler of milk.
From one pint to two quarts of milk according to age will maintain
the nourishment of anyone over days and weeks at a time and gradu-
ally the different broths, as chicken or lamb and beef tea, may be added,
and later bread and butter, boiled custard, rice and tapioca puddings.
Anointing the skin with vaseline at night and washing off in the
morning with suds removes the poisonous scales, and lessens the
danger of contagion, as well as improves the activity of the skin.
Nasal and aural catarrhal diseases are commonly observed to follow
scarlet fever and need attention of a physician. Rheumatism like-
wise is a frequent sequela, while nephritis or inflammation of the
kidneys is often a sad reminder of the disease. These two compli-
cations are to be treated as directed elsewhere.
160
SKIN DISEASES.
TABLE EXHIBITING THE DIFFERENCE BETWEEN SMALL-POX, VARIO-
LOID, SCARLET FEVER AND MEASLES.
SMALL-POX.
First. Period between exposure and when dis-
ease first shows itself is from five to twenty days —
usually shows itself in ten or tweive days.
Second. The fever and temperature is high, but
is less after rash appears.
Third. The rash appears on third or fourth day
and is seen on the forehead or some part of face.
Fourth. The eruption first consists of pimples,
then watery blisters which become white and sink
in the center.
Fifth. The tongue is coated and swollen.
Sixth. The eyes do not rim, and bronchitis does
not appear.
Seventh. Sore throat is often present but not to
as great an extent as in Scarlet Fever. Delirium
and convulsions may occur.
Eighth. Secondary fever appears after several
days.
Ninth. There are apt to be pocks and the eye-
sight be weakened, but by modern treatment it
can usually be avoided.
SCARLET FEVER.
First. Period between contagion and when dis-
ease first shows itself is usually from three to six
days, but may be much longer.
Second. Fever greatly increased and continues
without abatement after eruption appears.
Third. Eruption makes its appearance on sec-
ond day on the chest and neck and spreads over
the body during the next twelve hours.
Fourth. The eruption extends over the entire
skin.
Fifth. Eruption lasts from six to seven days
when it begins to come off in large scales.
Sixth. Tongue is covered with little red points.
Seventh. There is little trouble with bronchitis
or running of eyes.
Eighth. Sore throat.
Ninth. The mind is apt to be affected and there
may be delirium,
'Tenth. Usually no secondary fever.
Eleventh. In Scarlet Fever there is great dan-
ger of the patient being left with kidney trouble,
or the eyes, ears, or throat may be affected.
VARIOLOID.
First. Period of incubation more irregulai
than Small-Pox — from five to twenty days — av-
erages twelve days.
Second. Fever high till rash is well developei
and then a greater improvement than in Small
Pox.
Third. Eruption appears on third or fourtl
day.
Fourth. Rash consists of pimples, may go oi
to pustules and blisters, but usually subside be
fore advancing so far.
Fifth. Tongue coated and swollen.
Sixth. No nose or eye symptoms as a rule.
Seventh. Sore throat mild. Delirium and sev
erity of disease often marked at beginning bul
quickly subside.
Eighth. Secondary fever less marked than in
Small- Pox.
Ninth. Instead of rapidly convalescing, the
patient often shows an amount of weakness and
aniemia all out of proportion to preceding symp-
toms.
MEASLES.
First. Period between exposure and when dis-
ease first shows itself is from seven to fifteen
days.
Second. There is a moderate fever. It does
not decrease but increases after eruption.
Third. Eruption appears on fourth day on
face and spreads over rest of body in about two
days.
Fourth. Eruption is crescent-shaped, rest of
skin healthy.
Fifth. Eruption lasts about five days, then
peels off in scales.
Sixth. Tongue has red edges and is coated.
Seventh. The nose and eyes run and bronchitis
is usually apparent.
Eighth. Usually throat is not sore.
Ninth. The mind is not affected.
Tenth. The fever subsides after the third day
and there is no secondary fever.
Eleventh. The patient’s eyes may be inflamed
and consumption or bronchitis follow.
Small^Pox. - — Variola.
This is another disease characterized hy acute inflammation of
the entire skin, both external and internal, connected with infectious
and contagious fever. The eruption has the form of red points,
which soon become pimples, then vesicles, then flattened and scoojjed-
out vesicles, then pustules, and finally hard brown scabs. These last
fall off from the eleventh to the twenty-fifth day, and leave behind
them small pits and scars. The fever is remittent, and precedes the
eruption some three or four days, — ceasing when the eruption is
developed, and returning when it has reached its height. The
period between exposure and the attack of the disease, called inevr
hatiov,, is from five or six to twenty days, — being short iu the severe
cases, and longer in the milder ones.
Symptoms The disease begins with languor and lassitude, with
shivering, and pains in the head and loins ; with hot skin, and quick-
ened pulse and breathing ; with thirst, loss of appetite, and furred
tongue ; with nausea, vomiting, constipation, restlessness, and uni-
SMALL POX
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SKIN DISEASES.
161
versal prostration. To these symptoms sometimes succeed difficult
breathing, cough, drowsiness, and even insensibility. The tongue,
white at first, soon becomes red at the point, and over the whole
surface. The fever is highest during the night. The constitutional
symptoms are more violent just before the eruption, but immediately
subside, and soon disappear, when the breaking out is established.
The eruption is at first in the shape of small red points, which are
hard to the touch, and shaped like a cone, and are proportionate in
number to the subsequent pustules. In Plate II the artist has
well exhibited the developed disease, as well as the progress of the
eruption from day to day.
Treatment. — Like the two preceding diseases, the ordinary, un-
complicated form of this requires only the most simple treatment.
Not much is wanted, except confinement in bed, cooling drinks, cool
and even temperature, frequent change of linen, and sponging the
body with cool water. But when what is called the fever of inva-
sion is past, and the eruption is fully developed, and has brought
along with it the secondary fever, then some recipe, as (131), (356),
(125) will be in place, and some gentle laxative to keep the bowels
open (8), — also gentle injections (249), and opiates to relieve
sleeplessness and nervous symptoms ; (356) (357) may be used if
very sleepless.
Should the system, at this period, appear to be sinking, a more
generous diet, and a little wine may be allowed. If the brain
suffers, apply cold ice-cloths to head, or an ice-bag behind the ears,
and put the feet in a mustard bath (242). If the breaking out
appears with difficulty, put the patient into a warm bath, and give
extract of jaborandi (358). Gargles will frequently be needed for
the inflammation, and dryness of the mouth and throat (243).
Cold sponging may be considered as highly beneficial, in both the
primary and secondary fever. The belladonna likewise is a useful
remedy, used in the same way as in scarlet fever. The plaster (288),
applied to the face, will, it is said, arrest the formation of matter,
and prevent the unsightly scars which so often cover the face of
persons who have suffered from small-pox. Paint the face once or
twice a day with glycerine, which will effectually prevent pitting.
The use of flexible collodion is better.
To avoid Pitting, and the occurrence of unsightly scars of the
face, several methods of dressing have been used. The simplest
consists in covering in the vesicle with iodoform-collodion, say,
twenty grains of the former to one ounce of the latter. Having
pricked the vesicle with an absolutely clean needle, one, for instance,
that has been boiled in soda-water for five minutes, a layer of this
collodion should be applied and allowed to dry on at once. Should
pus form under this coating it must be released by washing off the
collodion with alcohol. The wound is then to be thoroughly disin-
162
SKIN DISEASES.
fected with carbolic acid water (one teaspoonful to pint of water)
and the collodion again applied.
This process will avoid most of the pitting.
Varioloid. — Mild Small-Pox.
Varioloid, or modified small-pox, begins with symptoms similar
to those of small-pox, but much milder in degree. These symptoms
are feverishness, nausea, vomiting, pains in the loins and head, and
a quickened pulse. The eruption comes out on the third or fourth
day, and looks like that of small-pox. It reaches its height the
fourth or fifth day, and then declines without any secondary fever.
The pustules dry up and form brown scabs which fall off in a few
days, and leave slight pits, and a few red or purple spots.
Chicken Pox. — Varicella.
Chicken-pox is a contagious disease, associated with mild fever and
a blister-like eruption called blebs over the body.
Symptoms. — The disease appears usually from two to three weeks
after exposure of the child to some one else similarly affected. At
first a mild fever and feeling of tiredness causes the patient to stay
indoors, though intense pain in the head, back and legs with high
temperature, vomiting and even delirium are not uncommon.
The eruption usually appears in one to three days and are small,
watery blisters averaging one-eighth of an inch in size. They are
more numerous over the chest and trunk, occasionally over the face
and forehead and even in the roof of the mouth. They do not have
the so-called shotty feeling when pressed to the bursting point under
the finger as in smallpox, neither is the red blush around them so
marked.
Unless scratched by the finger nails or a very severe case, very few
scars will remain.
Treatment. — The treatment is practically a mild diet for a few
days, keeping the patient indoors to avoid exposure to cold or wet
and some simple medicine as sweet spirits of nitre in dose of half a
teaspoonful in water every three hours to allay fever and keep the kid-
neys working properly.
Cow-Pox. — Vaccina.
This disease exists to some extent among lower animals, and is
identical with small-pox in man. The immortal Jenner taught the
world that the pus taken from the cov/ having this disease, and in-
troduced under the skin of man, would produce an eruption similar
to that of small-pox, and that this would protect the system from
the latter disease. This was an immensely important discovery, and
will render the name of Jenner famous through all time.
Before this discovery smallpox killed in England as many persons
ERYSIPELAS
SKIN DISEASES.
163
as all other diseases combined. To-day, if a person has even been
vaccinated once in their life the chance of death is only thirty out of
one hundred, while if never vaccinated about sixty per cent. die. If
vaccinated and the ‘‘scar” is plain, not over eight per cent. die.
It is usually a wise precaution to be re vaccina ted once in eight
years, especially if an epidemic of smallpox appears.
The Second Group of diseases, characterized by inflammation of
the true skin, without constitutional symptoms of a specific kind, are
Erysipelas, Nettle-Rash, False-Measles, and Inflammatory Blush.
Erysipelas. — St. Anthony's Fire.
Eeysipelas is a diffused inflammation of the skin, affecting only
a part of the surface of the body, and is accompanied by a fever,
which is generally thought to be infectious and contagious. The
local inflammation is disposed to spread; it extends deep, and is
attended by swelling, a tingling, burning, and pungent heat, and by
a redness, which disappears when the skin is pressed by the finger,
and returns on remitting the pressure.
Symptoms. — The constitutional symptoms are chilliness and
shaking, succeeded by heat ; lowness of spirits, lassitude, pains in
the back and limbs, pains in the head, quick and hard pulse, thirst,
loss of appetite, white and coated tongue, bitterness of mouth,
nausea, vomiting, pain in stomach, and costiveness.
These symptoms go before the local inflammation several days;
they increase with the redness of the skin, and disappear upon its
decline. The nervous system is sometimes severely affected, and
indicated by low, muttering delirium. At the close of the inflam-
mation there is generally a relaxation of the bowels, and the scarf-
skin peels off. Sometimes matter forms under the skin, and occa-
sionally mortification occurs. The face is the most frequent seat of
the disease. It commonly begins on one side of the nose, and soon
spreads over one side of the face, closing up the eye, and changing
the features in a shocking manner. See Plate III, Fig. 1.
Somewhere about the third, fourth, or fifth day, very minute blis-
ters appear on the inflamed parts, filled with water, which increases
until the blisters break and let it out. The disease comes to a head
on the eighth or ninth day, when the blistered parts dry, and the
skin begins to peel off.
Treatment. — In the treatment two things are to be done, — to
subdue the fever, and the local inflammation. The fever is assuaged
by rest, mild diet, gentle laxatives (26), (21), (125) ; and by the
use of tincture of veratrum. For the local inflammation, various
things have been advised, but nitrate of silver, on the whole, has the
preference. First wash the inflamed part with soap and water to
remove any oily substance, and wipe the skin dry. A solution of
nitrate of silver will in many cases, according to Dr. Higginbottom,
164
SKIN DISEASES.
do even better. Use a solution of 80 grains of silver nitrate to half an
ounce of water that has been boiled and then cooled. Apply with a
camel’s hair brush over the entire inflamed area and for a small
space beyond.
Apply two or three times to secure a firm coating but use carefully
to avoid sloughing. A perhaps better remedy than any is to apply
after washing with water and castile soap, a thick coating of icthyol
with vaseline equal parts. Cover this application with oil paper or
absorbent cotton as it will stain the clothes.
In mild cases, flour may be dusted on the inflamed part from the
dredging-box. Warm fomentations are also useful, and cloths wet
with water, and laid on. A solution of percliloride of iron, applied
to the inflamed skin, is much used now, or water as hot as can be
borne.
In erysipelas the powers of the system are generally reduced, and
tonics, such as quinine, wine, etc., are generally required. Dr.
Eobert Williams, — high authority in these matters, — says he puts
his patients upon milk diet, gentl}" opens the bowels, and gives them,
daily, from four to six ounces of port wine, together with sago, and
that he seldom has to change this course, whatever the symptoms.
For the inflamed skin, a tea made of buckwheat meal is a good
wash. Alcohol and water, or new rum, may be used for the same
purpose.
NettIe=Rash. — Urticaria.
Nettle-rash begins with fever, which lasts two or three days,
when wheals of various shapes, round, oval, and oblong, appear in
the midst of red, slightly elevated patches, attended by great itching
and tingling, as if the common nettle had been applied to the skin.
The wheals go off during the day, and come again at night. The
eruption is often a symptom of other diseases, or of mental anxiety.
Sometimes it is the effect of articles of diet. Children have it occa-
sionally while cutting teeth. A lighter form of the disease exists, in
which the wheals appear and disappear at short intervals, according
to the heat of the weather, the exercise, diet, etc.
Treatment. — The treatment varies according to the cause of the
disease. If this be anything offending the stomach, especially if it be
putrid fish, an emetic (2), (4) will be required, followed by brisk
physic (359). After which take a few doses of quinine (75). For
external application, the lotion (216) or common vinegar and water
(215) will be useful. Dr. Wilson recommends corrosive sublimate,
etc. (217), as the best lotion to apply outwardly. Soda bath better.
The diet should be simple and cooling, all stimulating food and
condiments being avoided. Fruit, candies, and berries often the
cause.
SKIN diseases.
165
Rose-Rash. — Roseola. — False Measles.
Symptoms. — The summer rose-rash appears first on the arms, face,
and neck, thence it spreads over the whole body, producing tingling
and itching. It is usually preceded by the symptoms of fever-chills,
succeeded by flushes of heat, languor, pains in the head, back, and
hmbs, restlessness, quick pulse, and thirst. The rash appears in
small irregular patches, paler than those of measles, and of a more
roseate hue. There is some hoarseness from inflammation of the
throat. The rash never continues more than five days, unless it be
merely partial, in which case it sometimes comes and goes at inter-
vals for weeks. If it “ strike in,” it generally produces disturbance
of the stomach, headache, and faintness, which are relieved by its re-
appearance.
The autumnal rose rash is in more distinct patches than the former,
of a circular figure, slightly elevated, and of a dark damask-rose hue.
Seldom any fever, or itching and tingling.
Treatment. — For the first-described form of the disease, light diet,
acid drinks, and gentle laxatives; for the second, recipe 69 or 51, ac-
cording to convenience.
Inflammatory Blush. — Erythema.
What is called marginated inflammatory blush, is a mottled, red,
smooth fullness of the skin, occurring on the extremities and loins, in
irregular patches, bounded on one side by a hard, elevated, red border.
This species of disease attacks old people, and indicates some inte’..-
nal disorder, which is dangerous.
Another form of the complaint appears on the arms, neck, and
breast, in extensive, bright-red, irregular patches, slightly elevated.
The redness, at its height, is very vivid, and continues about a fort-
night, when it assumes a purplish hue in the centre.
Treatment. — .Light diet, gentle purgatives (21), soda bath to al-
lay the tingling and secure sleep, and the mineral acids (63), with
bitter tonics, comprise all that is required, except sponging with
water, and friction.
Watery Pimples.
We now come to a class of diseases character.zed by watery pim-
ples. Wilson says they are distinguished by “ effusive inflammation of
the derma,” which means that there is inflammation of the true skin,
which causes water to be poured out on top of the derma, and under-
neath the scarf-skin, causing the latter to be lifted up in the form of
small or large blisters, or vesicles. At first the fluid in these pimples
is transparent, but in a short time becomes milky. Sometimes this
fluid absorbs ; at other times, it dries up, and with the cuticle scales
off as scurf.
166
SKIN biSEASEg.
Eczema and Salt Rheum.
Eczema is an inflammatory, acute or chronic, non-contagious skin
disease characterized at first by redness, little pimples, vesicles or
pustules and is attended by more or less burning itching. This pro-
cess terminates either in the formation of crusts as the lesult of dried
sticky serum, or else in the formation of fine scales.
No skin disease has such a variety of aspects nor such grades of
inflammation. There is generally more or less oozing of the blood-
serum, which dries and thickens, forming crusts. There is usually
more or less thickening of the skin, making it like leather; there is
generally some considerable scaling.
Eczema may subside in a few weeks never to return, or, what is
more probable, may lapse into a chronic state and continue for months
and years, with bothersome symptoms, which are extremely annoying.
5alt Rheum is a chronic eczema of this last variety.
Treatment. — In the acute stage of eczema, soothing lotions, pow-
ders, or ointments should be used, such as 372, 373, 374. Some are
better treated with powders, some by lotions ; the itching and heat
are best, relieved by 373.
In the more chronic variety some stimulating ointments are needed,
like 375. Carbolic acid, 10 or 15 grains to the ounce of oleate of
zinc ointment, is an admirable remedy for the itching and burning.
Salicylic acid, 10 grains to the ounce of benzoated zinc ointment
is likewise very serviceable, while tarry preparations generally are
the most satisfactory in this chronic stage.
No skin disease, however, is often so stubborn to treatment as the
different forms of eczema. The cure often will be slow and medi-
cines frequently changed. The local varieties of eczema require spe-
cial treatment.
Eczema of Head in Children. — After oiling freely the crusts over
night and washing off with suds in the morning, apply Salicylic acid,
1 part, tincture benzoin, 2 parts, vaseline, 50 parts. The very chronic,
thick, and indurated skins require 360, and in many cases 219, espe-
cially the chronic hand-cracks. The diet must be free from irritating
articles of food, the bowels regulated and the hygiene of the skin at-
tended to, while tonics and general systemic measures are often called
for.
Tetter — Shingles. — Herpes.
After a slight feverish attack, lasting two or three days, clusters
of small, transparent pimples, filled sometimes with a colorless, some-
times with a brownish lymph, appear on the cheeks or forehead, or
on the extremities, — and at times on the body. The pimples are a
little larger than in eczema, — about the size of a pea. After a few
SKIN DISEASES.
167
days the vesicles break, pour out their fluid, and form brown or yel-
low crusts, which fall off about the tenth day, leaving the surface red
and irritable. The eruption is attended with heat, itching, tingling-
ever and restlessness, especially at night. Ringworm is a curious
torm of herpes, in which the inflamed patches assume the form of a
ring. Shingles usually attack the aged about the ribs of one side,
and are evidences of impaired health and nutrition. They are very
prostrating and require tonics from the start.
Treatment.— Light diet, gentle laxatives. If the patient be ad-
vanced in life, and feeble, a tonic (75) will be desirable. For exter-
nal application, belladonna (173), or an ointment of sulphuret of lime,
(174), or elder-flower ointment, etc. (175). Equal parts of chloral
aud camphor applied several times a day, especially later in the disease
(361), give most relief.
Itch. — Scabies.
To this disease all classes are liable, though it is much less com-
mon than in foriner years. It is found frequently among the poor,
whose condition in life does not give them the means to guard at all
S dSnefs
Symptoms.- An eruption of distinct, cone-like, watery pimples
which are transparent at the summits, and are accompanied by an ex-
cessive Itching, which is made worse by high-seasoned food, by drink-
er ST ^^^heat of the bed. When these pimples are
scratched and torn, a sticky, watery fluid is poured out, which forms
small scabs ; and, in time, if the disease is not cured, these scabs be-
ing torn off, extensive sores are made.
anS! wonder of many readers to state that
animals of so small a size as scarcely to be seen with the naked eye
exist in the skin of man. Yet such is the fact ; and it is the present
of these minute creatures, or the effect of their presence, which con-
leuD-ih seventy-seventh part of an inch in
heautff;.! J inspected under the microscope, is really a
beautiful, I may say an elegant, animal. Here are a front, a side, and
a back view of him, well done by the artist.
168
SKIN DISEASES.
Fig. 73. Fig. 74. Fig. 76.
His Method of Attack. — When placed upon the skin, the little
fellow, like the squirrel and other ground-animals, sets himself to
make a hole through the scarf-skin with his head and fore feet. Into
this he pushes his whole body. He then begins to burrow himself in
the derma or true skin — making a channel many times his own
length, at the end excavating a chamber where he sleeps, and whence
he goes out to do his day’s work at mining, or boring for food. When
tired of this sleeping apartment, he digs onward and scoops out an-
other.
This travelling, and boring, and turning about in an organ as sen-
sitive as the true skin, must, of course, occasion a tickling and itch-
ing; and from this circumstance the disease took its name of itch.
But this itching is not painful. James the First is said to have re-
marked that the itch was fitted only for kings — so exquisite is the
enjoyment of scratching. Probably it is a royal luxury. Be that as
it may, most persons would consent to have it all done by royal fin-
gers. They have been used for meaner purposes.
Treatment. — Whatever will kill the little animal described above,
will cure the itch. Various agents have been employed for this pur-
pose, but none have been found equal to sulphur. The compound
sulphur ointment is a sovereign remedy for the disease. Four ounces
of this should be well rubbed into the skin, before the fire, morning
and evening, for three or four days. This will put an end to the
whole colony of these sovereign squatters upon forbidden soil.
Two ounces of sulphuret of potash, and the same amount of soft-
soap, dissolved in a pint of water, and applied well to the skin, is
used in many cases with good effect.
Caustic potash, one part to twelve parts of water, applied in a sim-
ilar way, is said to be a pretty sure remedy.
A solution of the chloride of lime, used as a wash, will often effect
a cure.
The ointment of the American hellebore sometimes does well.
Before applying any of these preparations, let the skin he washed
with warm water and soap, and well dried. Be sure the parasite is
SjKlN DISEASES. 109
bsfore 063-8111^ treatment. Best to continue few days longer
than what is apparently needed.
Rupia.
This is from a Greek word which means dirt, from the dirt-colored
crusts which are formed after the breaking of the large watery pim-
ples. The vesicles are like those of eczema and herpes, except that
they are larger. This is distinguished from all other skin diseases by
the formation of unhealthy, foul, and burrowing sores, which pour
out a reddish matter in such quantities that it collects and dries upon
the sore, and forms a crust of great thickness, — sometimes of the
size of an oyster-shell. Rupia has its origin in a weakly and debili-
tated constitution, and cannot be cured without renovating the whole
system. It is a manifestation either of syphilis or lupus.
Treatment, — arm baths once or twice a week, with generous
and nutritious diet. Tonic medicines (63) (51) (67) (61) (65) will
be required. For external treatment, dust the surface of the ulcers
with cream of tartar, or apply nitrate of silver (214) (219) (220)
white vitrol, etc. See syphilis. ^
Pemphigus. — Pompholix.
The first of these terms is from the Greek, and means a bubble ;
the second, pompholix, is from the same language, and means a water-
bubble. This is still more applicable to the disease in hand, which
consists, in fact, in the raising up of the scarf-skin in the shape of
bubbles, containing a watery fluid. These bubbles are just like com-
mon blisters. They vary from the size of a split pea to that of a
hen’s egg. They rise up very rapidly, and break in two or three
days, leaving a raw surface which soon becomes covered by a thin
crust.
Treatment.— Similar to that for Rupia, with the addition of iodide
of potassium (140), and applying the stick nitrate of silver to the
whole surface of the ulcer, and a short distance beyond it on all sides,
or the ointment (176). See treatment for syphilis.
Mattery Pimples.
Another natural group of skin diseases are distinguished by an
eruption of pimples, filled, not with water, like those just described,
but with matter. The pimples of this class are not transparent, or
whitish, but opaque and yellow from the first. The matter is poured
out upon the true skin, and raises up the scarf-skin, in the same way
as the watery pimples. As in the preceding diseases, too, the drying
up of the matter forms crusts. But these pimples are never so small
as those of eczema, nor so large as those of pemphigus.
170
SKIN DISEASES.
Crusted Tetter. — Impetigo.
This eruption consists at first of slightly-elevated pustules or pim-
ples, closely congregated, with an inflamed border. These break, and
the surface becomes red, excoriated, shining and full of pores, through
which a thin, unhealthy fluid is poured out, which gradually hardens
into dark, yellowish-green scabs. These scabs sometimes look like a
dab of honey dried upon the skin. This has given impetigo the name
of “honey disease,” or honey scab. This honeyed look is well repre-
sented in the crusts which form on the lips and ears of children.
Sometimes these scabs cover nearly the whole face, and are called the
milk crust. This is putting the agreeable words milh and honey to
rather questionable uses ! When this crusted tetter invades the head
or scalp, it causes the hair to fall, and becomes what is called a scall.
Impetigo may be simple, or contagious, or syphilitic.
Treatment. — The vapor bath, and water dressing. The following
ointments are useful : oxide of zinc, white precipitate, or diluted ni-
trate of mercury (178). Hydrocyanic acid (221), applied externally,
has a fine effect. The crusts sliould first be removed by a weak lye
made from hard- wood ashes, or potash ; then, after applying one of
the ointments above, or the lotion, cover the part with oil-skin. If
the crusts are on the head, the hair should be cropped off before the
remedies are applied. When of syphilitic origin, treat as for that
disease.
Papulous Scall. — Ecthyma.
The mattery pimple called ecthyma is developed on a highly in-
flamed skin. The bladders are about the size of a split pea, and are
surrounded by a broad ring of redness. They are generally separate,
not clustered like impetigo. They are scattered over various parts of
the body, and are followed either by a hard black crust, or by a sore.
The disease is either acute or chronic. The latter attacks weakly
children, and persons reduced by sickness or low living.
Treatment. — For the acute form, give a generous diet, with oint-
ment (176), and the cold sponge-bath on the sound parts. Use
(176) (175) (214) (211) for external application. Hygienic treat-
ment, tonics, and stimulants are called for ; iron, quinine, arsenic, and
nux vomica.
Scaly Eruptions.
The scaiy eruption is called a dry tetter. It is an inflammation of
the true skin, and is distinguished from the rashes and pimples by
the alteration of the scarf-sHn. The diseases forming this group are
three in number, — lepra, psoriasis, and pityriasis.
SKIN DISEASES.
171
Leprosy. — Lepra.
In this disease, the eruption makes its appearance as a small, sal-
mon-red spot, raised a little above the surrounding skin, and consti-
tuting, in fact, a flat pimple, almost as large at the top as at the bot-
tom. On top of this pimple the scarf-skin becomes rough, and after
a little while a thin scale is produced. New layers are added to its
under surface, and it accordingly grows thicker. It has a bright,
silvery lustre. These scaly spots multiply, and become the form of
leprosy called lepra guttata, from the Latin gutta, a drop, the scales
looking like drops of water on the skin.
But the eruption more frequently spreads out into circular patches,
of the size of a flfty-cent piece. These generally appear below the
elbows and knees, and on the breast and shoulders, and back of the
hands. Sometimes the entire hand is covered with scales of a pecu-
liar silvery whiteness. These patches heal from the centre.
Psoriasis.
This differs from lepra in the erupldon being more irregular. The
spots sometimes come out in thick clusters, and blend in various
ways. Instead of appearing in distinct circular forms, as in leprosy,
the patches are irregular, and of every size. Instead of one well-
formed and thick scale, there are many small and thin ones. And
instead of a depressed centre with rising edges, the surface is level.
While leprosy is a circular dry tetter, this is an irregular dry tetter.
Treatment. — Pyrogallic acid in ointment, 10 to 40 gr. to oz. Ap-
ply daily ; it discolors the skin for a while. Chrysoplianic acid in
same strength is the best remedy known. It also discolors the skin
and inflames the neighboring skin for a while. Recently the thyroid
gland of the sheep has been used in five-grain tablets three times
daily as an internal medicine with much success.
Pityriasis.
This is much like the two preceding, except that it gives rise to
a copious production of very small bran-like scales. Indeed, its name
is from the Greek, and means chaff or bran. It is a branny tetter.
It may occur on any part of the body.
Treatment. — When the skin is highly inflamed and stiff with heat,
pain, and itching, the diet should be light, and the drinks of a cooling
and unexciting kind. The warm bath and gentle friction of the skin
are useful. Laxatives or tonics may be employed, according to the
indications, — frequently laxatives first, and tonics afterwards. The
specific remedies for curing the disease are unknown ; iodide of potas-
sium (140), arseniate of iron (68), Fowler’s solution, in two-drop
doses, three times a day •, or Donovan’s solution, in five-drop doses.
172
SKIN DISEASES.
three times a day. For external application, use a naphthaline oint-
ment (177), zinc ointment, white precipitate ointment, diluted nitrate
of mercury ointment, or solution of corrosive sublimate (212).
Dry Pimples.
These are distinguished by the high degree of irritation of the
skin which they create. They are exceedingly troublesome, not only
from the distress and itching they occasion, but because they are
likely, in consequence of this, to be torn into painful and obstinate
sores.
When appearing in children, they are called red gum, and tooth-
rash. In grown persons, one form is named lichen, and another, dis-
tinguished by excessive itching, prurigo.
In this form of pimples, the fluid is not poured out upon the sur-
face of the true skin, — as in several of the preceding diseases, — but
is collected within the tissue of this organ, and the pimples feel hard
under the finger.
The tooth-rash of infants is always accompanied with some fever-
ishness, caused generally by irritation of the gums from growing teeth,
occasionally by flannel worn next the skin.
Lichen has a variety of forms. In one case the pimples are of a
bright red, in another, bluish or livid. In one case they appear in
circular groups, in another they produce great disorganization of the
skin, and occasion terrible suffering.
Prurigo is a stiff more cruel disease than lichen. The pimples are
not very manifest, but the skin is thickened or swollen, and con-
densed. The suffering from it is terrible. It gives one no sleep,
night or day. That form of it called ant-bite prurigo gives the sen-
sation of millions of ants eating the flesh, or as many red-hot needles
piercing it. This renders the existence of many elderly persons a
terrible burden.
Treatment. — Careful diet, and gentle aperients and tonics, accord-
ing to the condition of the system. Externally, the cold salt-water
sponge-bath, and glycerine, vinegar and water, applied with a soft
sponge. Tar and sulphur are among the more successful remedies in
fighting this rebellious disease (362). Iron, quinine, cod-liver oil.
For relieving the terrible itching of the private parts, which females
sometimes suffer, I have found morphine (223), for external use,
very effectual.
Lupus.
This makes its appearance in the form of one or more circular
elevations, of a duff red or salmon-color, and partially transparent.
When pressed under the finger, these elevations are found to be soft.
SKIN DISEASES.
173
and when the finger is removed, they are flat and whitened. They
generally appear on the face, and particularly the nose.
In another and worse form of the disease, the tubercles are harder ;
and after a time, they become covered with thin brown scabs, winch
are scratched off, and followed by others,
and these by others, until ulcers appear,
which are sometimes slow and sometimes
rapid in their progress. The whole nose
has been destroyed by them in a month.
(See Fig. 76.) This is one of the dis-
eases which Erasmus Wilson thinks, and,
in my judgment, correctly, to be, like
scrofula, the result of tubercular poison,
filtered through the blood of several
generations. It is a disease which is the
most destructive in the shortest time of
all diseases.
Treatment. — The internal remedies
are iodide of arsenic (141), and iodide
of potassium (140) ; the external, vine-
gar of Spanish flies ; and to promote the
healing of the ulcers, a weak solution of nitrate of silver (211) (214)
is adapted.
Hardly any disease has been treated by so many different remedies.
At present the prospect of a cure is good, as certain anti-tubercular
lymph injections have been found effective ; but no time should be
lost in immediately consulting a surgeon, as its growth can be ar-
rested, and the disease may be exterminated by early treatment.
Warts and Corns. — Verruca — Tylosis — Clovus.
In the derma or true-skin there are a great many small arteries,
veins, and nerves, united together, and formed into loops (see Fig.
43), resembling, in shape, the peaks of miniature mountains. These
are called papillce. These loops, frequently, without any apparent
cause, take on a disposition to grow, and by extending themselves
upward, they carry the scarf-skin along with them, which is thickened;
and together they form what is called warts. Corns are formed by a
somewhat similar growth of the papillae, brought about by the pres-
sure and friction of tight boots and shoes.
Treatment. — For warts, take a piece of diachylon plaster, cut a
hole in the centre the size of the wart, and stick it on, the wart pro-
jecting through. Then touch it daily with aqua fortis. Nitrate of
silver sometimes answers well for touching it. They may be taken
off very neatly, sometimes, by t3dng a string tight around them.
Corns should be shaved down close, after being soaked in warm
174
SKIN DISEASES.
water and soap, and then covered with a piece of wash-leather, or
buckskin, on which lead plaster is spread, a hole being cut in the
leather the size of the corn. They may be softened, so as to be easily
scooped out, by rubbing glycerine on them. Manganic acid destroys
warts and corns rapidly. Bunions, which affect the joint of the great
toe, must be treated with fomentations, and sugar of lead water
(224), when there is considerable inflammation, with rest in a hor-
izontal position. But the best cure for corns and bunions is to put
away tight shoes. Wear a bunion-plaster for some time to take the
pressure off of the corn or bunion.
Mother’s Marks. — Naevus.
The small vessels of the skin, called capillaiies, suffer certain al-
terations of structure which pass under the name of mother’s marks.
These marks are simply a great dilatation of these minute blood-ves-
sels. They vary in size from a mere point to a patch of several
inches square.
The smallest of all is the spider mark. It is a small red point,
from which several little straggling vessels spread out on all sides.
Sometimes this is of the size and appearance of a red currant ; at
other times, of a strawberry or raspberry ; and occasionally it is even
much larger, and is compared to a lobster.
When the circulation is active through them, or the individual is
excited by exercise, or by moral causes, these marks are of a bright
red color. Some are naturally livid and dark-colored, and look like
blackberries, and black currants. The blueness of these is owing to
the vessels being still more stretched and dilated, and to the conse-
quent slower passage of the blood through them, which gives more
time for its change from the arterial red to the venous blue.
Treatment. — If the mark is not making progress, it had better be
let alone, or only subjected to gentle pressure by putting a piece of
soap-plaster over it. When its course is threatening mischief, it is
sometimes cured by pencilling a small portion of its surface, from
time to time, with nitric acid. They may be operated on with safety
by electrolysis and other methods.
Disordered State of the Nerves of the Skin.
Itching. — Pruritus. This is supposed to be dependent on an al-
tered condition of the nerves of the skin, and consists in a painful
sensation of itching. There is no perceptible alteration in the ap-
pearance or structure of the skin. Tliis itching is thought, generally,
to be a result of sympathy, through the nerves, with some diseased
and excited condition of a distant part. The itching is brought on
by the most trifling causes, and for hours may deprive the sufferer of
every particle of repose. It more frequently affects the fundament,
or the private parts, particularly the scrotum.
SKIN DISEASES.
175
Treatment. — As this disease is only a symptom of several others,
the constitutional treatment belongs under the heads of these other
diseases. The local applications for relieving the itching are, a solu-
tion of sugar of lead (224), hydrocyanic acid (363), of corrosive sub-
limate (212), diluted nitrate of mercury ointment, and poppy fomen-
tations. Also (223). Tonics are often of first importance. Weak
solutions of carbolic acid or soda water at times suffice.
Disorders Affecting the Color of the Skin.
Colored Patches. — Maculce. The depth of color in the skin de-
pends on the amount of a certain coloring matter, called pigment, in-
corporated with the deeper and softer portion of the scarf-skin. In
the scarf-skin of the inhabitants of northern latitudes, there is but
little of this pigment ; in that of the dwellers of Africa, there is a
great deal ; among the inhabitants of Southern Europe, the quantity
is intermediate between the two.
The depth of color in the skin depends on the energy of its action.
In the tropics, where light and heat are in excess, the skin is stimu-
lated to great action, just as vegetation is, and the color is increased
and intensified. This is illustrated 6very year before our eyes. In
summer, under the heat of the sun and the flood of light, the pigment-
forming power is increased, and the fairest skin is browned ; while
the withdrawal of these forces leaves the winter’s scarf without pig-
ment, and blanched.
What the sun and light do, under natural circumstances, diseased
action may effect. Hence we occasionally meet with alterations of
color in the skin, from a disordered state of the system. We witness
the formation of patches of dark color and irregular shape on various
parts of the body. Sometimes they are raised above the level of the
skin, and are called moles. At other times, they have no elevation,
and spread over the whole body.
Occasionally, from some peculiarity of constitution, the pigment is
diminished, and white patches appear all over the body. At other
times, a black person will become completely white. Such are called
albinos.
In many cases the coloring of the skin has varieties of tint, as when
persons of light complexion, are, in the summer season, covered with
yellow spots, like stains. These spots are known by the name of
freckles, or, in learned language, lentigo.
Treatment. — It is generally best not to meddle with a mole. If it
be very unsightly, let it be removed by two incisions, taking out an
elliptical portion of skin, and closing the wound with sticking plaster.
In the case of bleached places, apply the shower bath, tonics, and a
stimulating liniment (163) to the faded spots. For the change of
color called sunburn, a liniment (191) of lime-water, etc., is the best
preparation. For freckles, use recipe 360, or, perhaps, still better,
364.
176
<SK1N DISEASES.
Disorders of the 5weat=Qlands.
The perspiration is sometimes greatly increased above nature’s de-
sign. This is, technically, idrosis. In other instances there is too
little sweating. This is called anidrosis. Sometimes the perspiration
is so altered in its physical qualities as to have some peculiar smell.
This is osmidrosis. In some rare instances, according to old writers,
the sweat was changed in color. This was chromidrosis. And now
and then a case occurs of bloody perspiration, of which the most
memorable case on record is that of the Redeemer of men, who, in
the garden, sweat great drops of blood. Several cases of this are re-
corded in medical books. It is called hcemidrosis.
The proper action of the skin being so vitally important to health,
these changes often involve very serious consequences.
Treatment. — Either too much or too little sweating can generally
be corrected by the cold or warm bath, friction, tonics, and proper
clothing. Small doses of jaborandi, also ergot and strychnine, are
among the best internal medicines (365).
Disorders of the Oil=GIands and Tubes.
That tbe skin may be limber, healthy, and fit for use, it is neces-
sary to have it oiled every day. For this object, the Creator has
wisely provided, by placing in the true skin a large number of very
small glands and tubes,* whose office it is to prepare and pour out
upon the surface the proper amount of oil. The gland, regular little
oil-pot, is in the true skin ; and from it a piece of hose or tube runs
up through the scarf-skin, through which the oily fluid is poured out.
Some of these tubes are spiral, others are straight. On some parts
these vessels do not exist ; on others they are quite abundant, — as on
the face, nose, ears, head, eyelids, etc. They produce the wax of the
ears ; and on the head, they open into the sheath of the hair, and fur-
nish it with a hair-oil or pomatum better than the chemist can make.
These little vessels are always at work, when the skin is healthy ;
and no persons need be afraid to wash all over every day, lest, as the
Boston Medical Journal taught, the skin will be injured by having
the oil removed from it. You might as well be afraid to eat a
meal of victuals, lest the saliva should all be swallowed with it, and
none be left for future use. There is oil enough where that upon
the skin comes from, and the vessels which produce it are not injured
by work, any more than the muscles of the legs are by walking.
Grubs or Worms. — But, unfortunately, the skin is not well taken
care of in all cases, as in cities and towns where sedentary habits pre-
vail. Here, the actions of the skin, instead of being regular and com-
plete, are often sluggish and imperfect ; and the contents of the oil-
cells and tubes, instead of flowing easily, become hard and impacted,
and the vessels are not emptied. When this matter becomes station-
SKIN DISEASES.
177
ary, dry, and hard, it distends the tube, and fills it to the surface ; and
then coming in contact with the dust
and smoke of the atmosphere, the ends
become black, and look like the heads
of worms. These spots are common
on the nose and face of persons who
have a sluggish skin. They may be
squeezed out by pressing the nails on
each side of them. These are called
grubs and worms^ or, technically, come-
dones. When this matter produces in-
flammation of the tube, there is then a
black spot in the middle of a red pimple,
and the disease is called spotted acne.
Now and then the oily matter becomes very hard, producing spine-
like growths, and even horns (Fig. 77) ; and again, it collects and
forms soft tumors, as wens, etc. These are technically called encysted
tumors. Sometimes the action of the glands is too great, and oil is
poured out so profusely that the face shines with it. At other times
there is so little that the skin is dry and harsh. In the hardened
oily matter, which constitutes grubs, are found small animals, which
Dr. Wilson calls the “animal of the oily product of the skin.”
Below are three views of him.
Treatment. — For roughness and harshness oi skin, wash with soap
and water every night, and rub well into the skin after the bath, and
in the morning, the ointment (362), and take a dose of sulphur, etc.
(23), twice a week. Or, rub the skin every morning with a damp
Fig. 78. Fig. 79. Fig. 80.
sponge dipped in fine oatmeal, and after drying the surface, the link
ment (164) may he applied. The spinous variety, or porcupine dis-
ease, requires washing with a quart of warm water, having a large
178
SKIN DISEASES.
tcaspoonful of saleratus dissolved in it, and the use of the ointment
(181) twice a day. For grubs, stimulate the skin by washing it
with strong soapsuds, twice a day, and rubbing briskly with a coarse
towel; and by using the corrosive sublimate (225) as a lotion.
A spare diet will do much towards improving the skin in many
cases; use tonics in others. Usually, destroy the old skin first (360)
and apply after (362) to heal.
Barbers’ Itch. — Jackson’s Itch. — Sycosis.
This is very much like ac?ie, — only differing from it in its loca-
tion. It appears chiefly on the hairy parts of the face, — the chin,
the upper lip, the region of the whiskers, the eyebrows, and the nape
of the neck. It consists in little conical elevations, which maturate
at the top, and have the shaft of a hair passing through them. These
pimples are of a pale yellowish color. In a few days they burst, and
the matter running out, forms into hard, brownish crusts. These
crusts fall off in one or two weeks, leaving purplish, sluggish pimples
behind, which disappear very slowly.
The eruption is preceded by a painful sensation of heat, and tight-
ness of the skin.
Barber’s Itch.
Barber ’s itch is a variety of ringworm though confined to the
region of the face covered by the beard. Whether of the body, the scalp
or the face, this disease is highly contagious, being communicated to
other persons through the medium of soiled hands, unclean towels,
razors, strops, brushes, etc. A vegetable fungus called the tricho-
phyton is the source of the infection.
Symptoms. — Small reddish pea-sized rings with minute vesicles or
watery blisters appear, they spread, branny scales form, the blisters
maturate, itching becomes noticeable and other areas rapidly take on
the same appearances. The surrounding skin becomes congested and
reddened, a gluey, yellowish, sticky fluid exudes from the scabs and
thicker crusts pile up on each other. The hairs of the affected part
break off very easily or fall out.
As this disease is so contagious, great care should be taken to use
individual towels, that the face should be shaved if possible by the
person afflicted and of course kissing the children or holding their
cheeks up against the infected cheeks must be i prohibited.
Treatment. — Although a tedious course may be expected to pre-
sent itself, yet the greater the care used the sooner a cure will be
eft'ected. First with almond or olive oil soften the parts for two
days, then shave every day or at least every other day, and after
washing off with warm water apply freely an ointment of twenty
grains of sulphur, fifteen grains of boracic acid mixed in half an ounce
of benzoinated lard. This salve should be well rubbed in and a
supply kept on the face, enough to make it look greasy day and
night until cured,
SKIN DISEASES.
179
Disorders of the Hair and Hair-Tubes.
The hair is an appendage of the scarf-skin, and is intended to be
both useful and ornamental.
It is subject to several disorders. It may grow too long, or too
thick, or it may appear in an improper place. This last happens in
the case of those little spots and patches which disfigure the face,
and are called moles. The hair may be defective in its growth, or
may fall off prematurely from various causes, or in the natural course
of things from old age. This last is called calvities. It may change
its color, too, under a great variety of circumstances, and at nearly
every age. It is not very uncommon to find a single lock varying in
color from that which surrounds it. Old age, the winter of life, nat-
urally brings the frosted locks; but they frequently appear also upon
the heads of younger persons. Strong mental emotions, such as fear,
grief, or sorrow, may bring a bleaching of the hair in a brief period,
or even suddenly.
Porrigo. — There is a troublesome disease of the hair and hair-tubes
called porrigo. It begins with the formation of a thin layer of scurf
either around single hairs, or in patches which enclose several. These
patches frequently have a circular form, which give to the affection
the character of a ringworm. The hair-tubes are generally a little
elevated, in the shape Df papillae, which gives to the diseased scalp
the appearance of “goose-flesh.” These hairs, losing their proper
nourishment and healthiness, break off at unequal distances from the
skin, leaving their rough ends twisted and bent, and matted into
thick grayish and yellow crusts. Upon the surface of these crusts
may generally be seen the ends of a few hairs, looking like the fibres
of hemp or tow. The scratching causes inflammation of the skin after
a time, and matter is poured out, which still further mats the hair,
and thickens the crusts. There are several varieties of this disease,
differing slightly from each other ; but this general description will
answer all practical purposes for this work.
The reader will often notice a disease of the hair-glands, character-
ized by a yellowish and dirty-looking powder, covering the scalp and
hairs. This matter is collected at the mouths of the follicles, and
considerable of it is strung upon the hairs like beads. Pull out a
hair, and the root will be found thin, dry, and starved in its appear
ance. In this disease, it is difficult to keep the hair cleansed, or to
prevent its falling off.
Favus. — Still another disease, called favus., is known by the collec-
tion of a yellow substance, at first, around the cylinder of the hair.
This substance, after a time, spreads out upon the scarf skin, and
dries into yellow crusts, in the form of a cup, around the base of each
hair. A number of these cups, collected together, look like the cells
of a honey-comb. This disease is contagious, and is communicable
by contact to any part of the skin.
180
SKIN DISEASES.
Treatment. — For removing the hair from particular parts of the
scalp, it is common to resort to depilatories. Of these, the recipes
260, 261, 262, are frequently used, and are as good as those adver-
tised; indeed, they are the same. Forceps are the best means.
To prevent loss of hair, and to restore it when lost, the circulation
should be stimulated in the small vessels of the scalp. With this
view, washing the head every morning with cold water, drying it by
friction with a rough towel, and brushing it to redness with a stiff
hair-brush, are excellent. To these should be added some stimulating
ointment (183), or liniment (257), (258), (259). These last are about
the best known preparations for causing the growth of the hair.
Ringworm of the scalp requires attention to the diet, and such
'remedies as will improve the general health, with stimulating appli-
cations externally (257), (258), (259). 366 is the newest and best
mode.
To color the hair, several preparations are used. Of these, 263 is
about the best. It produces a beautiful black. A preparation of sul-
phur and sugar of lead (264) is the famous compound recommended
by General Twiggs, and extensively used. Preparations of nitrate of
silver (265), (266), (311) are much in use in some quarters. They
perhaps give a finer black to the hair, but they render it dry and crisp,
and they will stain the skin, if care is not used in applying them.
Use care in the use of these remedies.
In Favus, the two great objects to be gained are, to remove all lo-
cal causes of irritation, and to excite the diseased hair-glands to
healthy action. The first object is affected by cutting off the hair
with the scissors, and removing the crusts by washing the scalp with
castile soap and water. It may be well first to wet the crusts through
with corrosive sublimate (212), in weak solution The washing with
soap and water should be repeated every day, and be followed by
rubbing into the scalp a stimulating ointment (183;. A very weak
solution of the nitrate of mercury (226), applied every other day,
with a camel’s hair brush, sometimes produces excellent effects.
Lice.
Pediculosis or Lice is a contagious, animal, parasitic affection,
characterized by the presence of pediculi in the skin and scratch-
marks of the sufferer ensuing from the annoying itching. There are
a number of varieties classified according to the peculiar parasite and
its location. They all cause great discomfort and itching.
The Pediculosis Capitis, or head-louse, is found in the scalp, and
is a long, oval body with six legs furnished with nails ; it has an oval
head with two prominent eyes and two horns. The ova or nits are
SKllt DISEASED.
181
small whitish bodies closely glued, to the hair
and look like small pieces of dandruff. One or
two are deposited on a hair.
They occur for the most part in poorly nour-
ished children brought up under bad hygienic
surroundings, and thence communicated to
others. They cause extreme itching and scratch-
ing, so that often the irritation is unbearable and
the sticky serum of the blood mats together the
hair, forming crusts. Sleep is often interfered
with and ill health results. (See Fig. 81.)
Pediculosis Corporis, or body-louse, is gen-
erally the property of the clothing ; it is some-
what larger than the head-louse and deposits its
eggs in the seams of the clothing, remaining on the body only long
enough to gain sustenance. The young are hatched in five or six
days. The louse reproduces again in
eighteen days. As the parasite crawls
about it produces extreme itching and
the scratching follows, resulting in long
lines of excoriation. The chief locations
for this parasite are the back, chest, abdo-
men and thighs. The middle-aged and
elderly are more apt to be attacked than
the young. Here uncleanliness again is a
prime factor in their occurrence. (Fig.82.)
Pediculosis Pubis, or crab-louse, is a
smaller, shorter, stouter parasite than the
two preceding, and attacks the pubes par-
ticularly, but is also found in the axillae
and over the eyelashes and beard of the
male. They may be seen clinging closely to
the skin with remarkable tenacity. They
occur on adults and produce the same lesions as the other varieties.
They are generally the result of promiscuous sexual intercourse.
(Fig. 83.)
Treatment. — The main object in the treat-
ment of these filthy diseases is the destruction
of the parasite. The lesions they produce
disappear with the disappearance of the ani-
mal. It need hardly be said that strict clean-
liness of person is a sine qua non. The rem-
edies usuall}'^ employed in their extermination
are the mercurials, sulphur, caibolic acid, to-
bacco, etc.
In case of the head-louse the most effica-
cious method of treatment consists in saturating the head over night
Fig. 82.
BODY-LOUSE.
Fig. 81.
HEAD-LOUSE.
182
SKIN DISEASES.
with petroleum and washing off with soap in the morning. In young
children the hair may be cut to get rid the more easily of the nits,
but this is not necessary. The applications of petroleum may have
to be repeated several times and the hair frequently washed with soft
soap, soda washes, vinegar, etc., to get rid of the nits. If the louse
be of the body variety the treatment must be directed to the clothing,
which is to be changed often and either boiled or baked. This pro-
cess is to be repeated until no more parasites are found. The itching
of the body is best allayed by carbolic acid lotions (one teaspoonful
to pint of water).
The crab-louse is best treated by the well-known mercurial oint-
ment, or blue ointment, and is to be washed off with soap and water
each morning. It must be persisted in till no more crabs are found
and no further itching is noticed.
Bed=Bugs.
The best preventives against these annoying bugs is corrosive sub-
limate and pyrethrum powder. Purchase a small bottle of the corro-
sive sublimate tablets, usually sold at the druggists for surgical pur-
poses, and dissolve one in a quart of water. This solution is to be
freely used about the cracks of the bed, after it has been taken apart,
and also about any wooden furniture of the room as well as the wood-
work of the room. The powder is then to be used freely. This pro-
cess is to be repeated several times.
The bites themselves are best relieved by carbolic lotions, vinegar
and water, ammonia and water, etc.
Freckles.
This is a disease of the pigment layer of the skin and consists in
a deposit of the coloring matter of the skin in irregular shapes,
of the size of a pin-head or pea, and are yellowish, brown or even
blackish, occurring for the most part on the face and back of the
hands. They may be few and scattered or exceedingly abundant
and cover a large area. All ages are subject to them except in very
young children. The light-complexioned are more subject to them,
while the red-haired seldom escape them. Sunlight develops them so
that many have them conspicuously only in summer. The possession
of freckles is a matter greatly of idiosyncrasy, as many people never
have them, no matter how much they may be subjected to the sun.
Treatment. — One’s aim in treatment should be toward destrojdng
the pigment layer by some corrosive agent, like corrosive sublimate,
which perhaps is the best remedy.
Two grains to the ounce in water will in most cases prove sufl&-
ciently strong. The susceptibility of the skin to this remedy and the
extent of the area involved have much to do with the strength of the
SKIN DISEASES.
183
remedy employed. This remedy is poisonous and is to be used with
care. Do not get it near the lips, but to effect a cure it must be per-
sisted in for quite a while.
Washing the face in buttermilk several times a day is excellent.
Corns.
Of all the minor ailments of the human body, few are more dis-
tressing than the inflamed corn. They consist of a thickening of the
outside or horny layer of the skin. As a secondary change, conse-
quent on long irritation, the nerve and blood supply increase and an
extreme tenderness is produced, amounting often to incapacity to
walk or work. They are caused mechanically by the undue pressure
of the boot against the joint or by one toe pressing against another.
Too short a boot, which causes pushing out of the big toe joint, too
narrow a boot, causing crowding of the large joints, are the more fre-
quent causes of the corn.
Bunion.
The bunion is produced by wearing too short a boot, as a rule, and
consists in the gradual displacement of the big-toe joint, so that fi-
nally there is an actual deformity. The corn usually is added to this
deformity.
Treatment. — The outer layers jf the corn should be softened and
scraped off by a sharp, thin knife. The softening process may be ef-
fected by soaking in a soda solution, or better still, by the following
mixture : —
Salicylic acid one-half ounce
Extract cannabis indica ten grains
Collodion one scruple
This is to be applied each night. Care is to be exercised in not
paring the corn too closely lest bleeding occur and poisoning ensue
from the unclean knife that may be used. Pressure of the boot must
be avoided by the substitution of another form of boot and also per-
haps by wearing a plaster with a hole in the center, thus distributing
the pressure over a greater area. When trimmed the corn is to be
likewise covered by a corn-plaster bound on the foot by strips of
adhesive plaster. Painting with iodine often takes out the sore-
ness and hardens the skin so that ^t may be more readily cut. In-
flamed corns should be poulticed and treated like any pus wound.
Spirits of turpentine will often take the soreness out of a corn. Ab-
sorbent cotton, or better, wool, worn between the toes, will prevent
or cure a corn between the toes.
Dandruff.
This is a disease of the sebaceous glands of the scalp, characterized
184
SKIN DISEASES.
by a large secretion of the sebaceous matter and forming crusts or
scales. The secretion may be so thick and oily as to mat together
the hair, or so dry as to fall off the head in a shower when the head
is combed. ' It is the most frequent cause of baldness. The crown
of the head is the most frequent location of this disease.
Treatment. — Inasmuch as those subject to this disease are often
below par in health, such constitutional remedies as cod-liver oil and
iron are valuable adjuncts in bringing about a cure. Should the
amount of scales be considerable, especially if there are crusts, as in
the case of little children, the best procedure consists in oiling the
scalp over night with some bland oil, wearing a flannel cap, and wash-
ing off the oil in the morning with soft-soap and water. The follow-
ing blood tonic is an admirable one for adults : —
Tincture of iron one ounce
Dilute phosphoric acid one ounce
Syrup of lemon two ounces
Take one-half teaspoonful in a wineglass of water three times daily.
Use a glass tube to avoid staining the teeth. The scalp needs a
shampoo once or twice a week ; the following will be found to be a
suitable one: —
Green soap. eight ounces
Alcohol four ounces
Put a little here and there over the scalp and then rub up with
warm water. The scalp may then be stimulated night and morning
with a little of the following lotion :[ —
Tincture of cantharides three drachms
Tincture of capsicum three drachms
Castor oil two drachms
Alcohol two ounces
Spirits rosemary two ounces
Another good remedy for daily use : —
Hydrate of chloral two drachms
Water four ounces
The yolk of two eggs well rubbed into the scalp and afterwards
washed off with hot water is also a good cleansing agent and sham-
poo. s,
For very stubborn cases the following lotion applied night and
morning will be found efficacious : —
Corrosive sublimate 12 grains
Glycerine 4 drachms
Alcohol 5 ounces
Spirits rosemary 4 drachms
‘ Whatever method is pursued, the application must be persevered
SKIN DISEASES.
185
in and applied from twice daily to once every few days according to
progress made and severity of case.
Baldness.
This disease is generally the outcome either of some constitutional
weakness and requires general tonic treatment like iron and cod-oil,
or is the result of some local lesion of the scalp proper. When due
to syphilis, the hair falls out suddenly and quite extensively ; the
eyebrows also suffer the same way. Its treatment is to be conducted
on the same plans as directed under treatment of the syphilitic dis-
ease. Eczema, scrofulous blood, etc., may also be the exciting cause
of baldness. Baldness may ensue in areas only, and oftentimes is as
complete as though no hair had ever grown there. This form is apt to
be very stubborn and requires very irritating treatment, like blisters
or the rubbing in of strong carbolic acid once a day for a number of
days before ceasing treatment.
The baldness of old age is of course irremediable, but may be ar-
rested by attention to the general health and the employment of rem-
edies mentioned under the consideration of dandruff.
As has been mentioned, dandruff is the most fertile source of bald-
ness. When once the scalp is clean and the dandruff is cured the
following lotion will be found to be of great value in those cases of
baldness characterized by the hair falling out in small patches : —
Carbolic acid one drachm
Alcohol one and a half ounces
Castor oil two drachms
Oil bitter almonds ten drops
The following lotion also contains desirable ingredients : —
Tincture cantharides . . . one and a half ounces
Tincture capsicum .... one and a half ounces
Castor oil two drachms
Cologne one ounce
WORD
( BLINDNESS
JfervQS and . Arteries of.Jhe Sram.. CGRR':^
DISEASES of the BRAIN and NERVES
DISEASES OF THE BRAIN AND NERVES.
(Also see Anatomy of Brain and Nerves.)
The brain and spinal column are the great centres of the nervous
system.
The brain produces sensation^ thought, and voluntary motion. When
this organ is diseased, therefore, we may expect one of these functions
to be either disturbed or destroyed.
Of Sensation there are various disturbances, perversions, and sus-
pensions, caused by disease of the brain and nerves ; such as nausea,
giddiness, specks floating before the eyes, ringing in the ears, decep-
tive tastes and smells, intolerable itching, neuralgic pains, boisterously
high spirits, depression without apparent cause, anxiety, and dread.
Thought, in like manner, is disturbed and perverted in many ways.
There is high delirium, dullness and confusion, loss of memory, weak-
ened judgment, and every degree of stupor", down to entire loss of
consciousness.
Voluntary Motion is perverted and destroyed in muscular twitch-
ings, trembling of the limbs, spasmodic stiffness, involuntary jerk-
ings, convulsions, muscular debility, and palsy.
The brain is composed of three parts, — the cerebrum, the cerebel-
lum, and the medulla oblongata. These are all contained within the
skull bones, and are immediately covered by three membranes, called
the dura mater, the arachnoid, and the pia mater. The dura mater is
a strong, fibrous membrane lying next to the skull-bones. The arach-
noid is a serous membrane, lying next below, and the pia mater, which
means pious mother, is a vascular membrane, lying next to the brain,
dipping into it in places, and containing the vessels which bring to it
all its nutrient materials. Hence its name.
These membranes are all liable to be inflamed, — and so is the
brain.
Inflammation of the Dura Mater.
The inflammation of this membrane does not often occur sponta-
neously ; but it happens frequently from external injuries, as blows
upon the head.
After a blow upon the head which stuns him, a man may recover
himself, and for some days remain in perfect health. Then he has
X88
frontal
Roral
ZVeOMA
BOn E
J^UPERIOI
i-LARV
DISEASES OF THE BRAIN AND NERVES.
189
pain in the head, is restless, cannot sleep, has a flushed face, red eyes,
hot skin, hard pulse, rigor, nausea, vomiting, — ending with convul-
sions and delirium.
This disease is often caused by what is called otitis, or inflamma-
tion of the internal ear. In such cases, inflammation will arise within
the tympanum, causing intense earache ; matter comes at length from
the external ear, but the pain does not stop ; the patient shivers, be-
comes drowsy, perhaps delirious, and finally sinks into stupor. The
dura mater is inflamed.
Treatment. — When the disease arises from inflammation in the
ear, leeches are to be applied behind the ear, and blisters and other
irritants afterwards. Other modes of treatment will be mentioned
after the next two forms of disease.
Inflammation of the Arachnoid and Pia Mater.
Arachnitis.
These two membranes are generally inflamed together. They
are so intimately connected that each involves the other in its own
troubles.
Generally this is divided into three stages : —
The Irritative, characterized by wakefulness, irritable temper, re-
pugnance to strong light, and contraction of the pupils.
The Inflammatory Stage, known by transient pains in the heack
alternating with similar ones in the bowels, increased restlessness and
irritability, a quick and tense pulse, an expression of discontent on
the face, the eye-brows knit and frowning, the eye-lids half closed,
retching and vomiting, deep sighing, and torpid ^wels.
The Depressing Stage, in which the delirium is more continuous^
the countenance has a look of surprise and stupor, the pupils are con-
tracted or dilated, the white of the eyes injected and red, the pupils
rolled up during sleep, constant sleepiness, inattention to surrounding
objects, torpidity of mind, gradually increasing until complete coma
closes all the senses.
The disease does not always exhibit all these symptoms, or come on
in the regular way described. Sometimes the first' thing noticed is a
long-continued' paroxysm of general con'vulsions. Again these con-
vulsions will come on after violent pains in the head, and are attended
with screaming.
Inflammation of the Brain. Brain Fever.
Encephalitis. — Phrenitis.
Acute and general inflammation of the brain and its membranes
has two stages.
The Stage of Excitement, in which there is intense and deep-seated
pain in the head, extending over a large part of it, a feeling of tight-
190
DISEASES OF THE BRAIN AND NERVES.
ness across the forehead, throbbing of the temporal arteries, a flushed
face, injected eyes, looking -wild and brilliant, contraction of the pupils,
great shrinking from light and violent sound, delirium, want of sleep,
general convulsions, a parched and dry skin, a quick and hard pulse,
a white tongue, thirst, nausea and vomiting, and constipation of the
bowels.
The Stage of Collapse, in which there are indistinct mutterings,
dull and perverted hearing and vision, double vision, the pupil from
being contracted expands largely and becomes motionless, twitchings
of the muscles, tremors and palsy of some of the limbs, a ghastly and
cadaverous countenance, cold sweats, profound coma, and death.
The disease will not show all these symptoms in any one case. It
runs a rapid course, causing death, sometimes, in twelve or twenty-
four hours ; or it may run two or three weeks.
Treatment. — This should be energetic, and administered early.
The measures usually employed are hot foot-baths, and the application
of cold to the head, with occasional mustard poultice to legs.
General Blood-letting. — This is much approved by many; for
rnyself, I do not like it. Wet cups and leeching are about the extent
to which I would ever carry the abstraction of blood in these diseases.
These may sometimes be applied with advantage to the neck, and be-
hind the ears.
Cold Applications. — These, applied to the head, are of great im-
portance. First, shave the head, and put on cloths wetted in water
as cold as it can be made, changing them often ; or, put powdered
ice in a flexible bladder, and lay it upon the head, — taking care not
to make it too heavy. Heat in a few cases is better borne.
Cathartics. — These, while the inflammation is in the active stage,
should be thorough and energetic. To effect it, many use calomel
and other forms of mercury. They are not needed. Croton oil is one
of the best articles (31), or colocynth, gamboge, etc. (32), without
the oil, or the compound powder of jalap.
In the stage of collapse, if there is pallor of the eountenance, a
feeble and flying pulse, great debility and tremors, coldness of the
extremities, etc., give wine and other stimulants.
See that the bladder is emptied every day.
The feet, in the early stage of the complaint, should be bathed in
warm water, or mustard and water (242). Mustard draughts must
also be put upon the feet.
The tincture of veratrum, given in full doses, to bring down the
pulse, and produce sweating, must not be omitted. Give (351).
Softening of the Brain. — Ramollissement,
Inflammation of the brain, when it has run its course, sometimes
leaves this organ, or portions of it, in a softened condition. The
DISEASES OF THE BRAIN AND NERVES.
191
same miscliief may happen to the brain from the blood-vessels which
run to it being diseased, so as not to be able to carry blood for its
proper nourishment.
Symptoms. — The most remarkable symptom of this disease is the
rigid contraction of the muscles which draw up the limbs ; the hand
may be clenched and pressed against the shoulder, or the heel carried
up to the hip.
The early symptoms are tingling, numbness in the ends of the fin-
gers, perverted vision and sometimes blindness. The person usually
tidy in habits and dress now becomes careless and slovenly. He
occasionally complains of sleeplessness and the temper becomes irri-
table and friends notice that he takes offense when usually he would
not notice. His forgetfulness is very noticeable at times to the
extent of forgetting his name and that of his family, later on the
symptoms are similar to those which will be described under the
heading “Dementia.”
Suppuration and Abscess of the Brain.
When a diseased brain is examined after death, sometimes matter
is found mixed in with the softened portion. This shows that suppu-
ration took place. At other times, the matter is found in a cavity,
which shows that an abscess had formed during life.
The symptoms of these mischiefs are convulsions in the earlier
stages, and palsy in the latter. Surgical methods now often save
life, and cause a cure in these cases.
Induration of the Brain.
Instead of softening the brain, inflammation sometimes does the
very opposite, — it hardens it, — producing a change something like
that which happens to white of egg when dipped in hot water.
Convulsions appear as the result of this change, as in suppuration
and abscess ; palsy much more seldom.
Tumors of the Brain.
Tumors infect the brain occasionally, — growing around it, on all
sides, pressing themselves into its substance, and causing many dis-
turbances. Cancers and hydatids are found there. The signs which
these irritating bodies produce are like those of other diseases of the
brain, and therefore cannot be distinguished during life. Syphilis is
often the cause of them, and, when due to this, may be cured.
Delirium Tremens. — Drunkard’s Delirium.
Mania a Potu.
This is often mistaken for brain-fever ; but it is quite a different
192
DISEASES OE THE BRAIN AND NERVES.
disease. It is not the result of inflammation of the brain, but of irri-
tation. It is important to distinguish it from inflammation, because
the remedies which are employed for that would be injurious if used
for this.
The Symptoms are incessant talking, fidgeting with the hands,
trembling of the limbs, a rapid pulse, profuse sweating, utter sleep-
lessness, and a mingling of the real with the imaginary in the busy
talk. The patient is apt to think some one is about to do him a
great injury, yet is unwilling to be alone. His face is pale and sal-
low (sometimes red and flushed), his eye is rolling, quick and ex-
pressive, his speech stuttering and inarticulate, — bodily and mentally,
he is busy day and night, and can with difficulty be confined to his
bed or room. As the disease advances, and he has been long without
sleep, he imagines vermin to be crawling upon his scalp and body ;
troops of rats run across his bed, or look at him out of the wall ;
giant boxers confront him, and he squares off for a round at fisti-
cuffs ; animals, figures of all shapes, and horrible monsters frighten
his imagination ; devils laugh at Ifim, and dance before him. In long
and sleepless hours, he talks and chatters with these spectral phan-
toms, — now beckoning them, now shrinking from them, till he wears
out and sinks from exhaustion. This is a disease of drunkards and
opium eaters. The attack generally occurs in consequence of the
withdrawal for three or four days of the accustomed stimulus.
If the delirium is the result of recent heavy drinking, an emetic should
be administered to empty the stomach of what is remaining there. Sul-
phate of zinc, 20 grains well diluted with water, or ipecac, 30 grains
may be given, after which a good cathartic such as 30 grains of
compound jalap powder for unloading the bowels mav be used. If
the patient is depressed and nervous, spirits of aromatic ammonia
may be used. In more marked cases, strong black coffee by the
mouth or rectum; even strychnine in 1-30 grain doses will be needed
for the heart. Bromide of soda, 30 grains dissolved in one-third
glass of water may be given every two hours to keep the patient quiet.
Morphia and the other preparation of opium, while very valuable,
should be used with great care ; 20 drops of laudanum every two hours
for two or three doses will usually, in conjunction with the bromide,
quiet the patient, but the exclusive administration of opium or giving
it in large amounts should be under the control of a physician. Bath-
ing the patient in the tepid bath, during which cold applications are
kept on the head, may be used for hours at a time if the patient does
not rebel at this treatment, but usually the quieter he can be kept
the sooner he will recover.
Inebriety. — Drunkenness.
In the beginning of the present century insanity was regarded as a
visitation of God’s displeasure and not as a disease subject to scientific
investigation and amenable to treatment. Inebriety is regarded now
DISEASES OF THE BRAIN AND NERVES.
193
as insanity was some hundred years ago, the disease being consid-
ered irremediable. Alcohol is a poison, and like other poisons is cap-
able of destroying life. In large doses it becomes a powerful irritant
or a narcotic producing coma and death. It being constantly intro-
duced into the system produces a general disease in the system. We
believe inebriety can be cured like any other disease, but is subject to
relapses like other diseases.
The “ alcohol habit,” under the title Inebriety, oftentimes has the
S3Tnptom or outward manifestation of diseased conditions, which an-
tedate the alcoholic craving, and are its predisposing and exciting
causes which retard, and sometimes even prevent a cure.
In the popular, and too often in the professional mind, alcohol is
regarded as the cause and root of the whole evil of inebriety. We
desire to assert that inebriety is frequently dependent upon causes
with which alcohol has nothing to do. There is a neurotic craving
— it may be congenital, it may be developed as the result of disease
or accident. This craving demands the various forms of narcotic
stimulants, those that first excite, then produce narcosis more or less
complete. Alcohol fulfills this condition, is easily accessible, reason-
ably inexpensive, and is the one drug that meets a morbid craving
that seems to be almost universal.
We do not fail to recognize the deteriorating effects of alcohol
manifested principally, at least, more pronouncedly upon the nervous
system as seen in the various forms of insanity. We also note the
degenerating effects of alcohol on lung, liver, kidney or other organs
and tissues of the body ; or as a special poison in the same sense that
lead, arsenic and tobacco produce their effects.
We believe that the great majority of inebriates become so from he-
redity, environment and disease, that produces physical degeneracy
and pushes them over and plunges them into inebriety.
The patient with fever craves and may drink water freely, exces-
sively and injuriously. The diabetic is an aqua-maniac in a certain
sense, but in neither case do we recognize the aqua-mania or water
craving as the disease, but rather as proceeding from certain abnor-
mal conditions which we readily recognize. So the liquor thirst is
the result of morbid conditions that produce an abnormal desire,
which alcohol seems, temporarily at least, to satisfy.
The excessive use of alcohol, while it is oftentimes the cause of
various diseases of the nervous system, and also a frequent cause of
insanity, is also the precursor or initiatory symptom of certain diseases
of the nervous system and also of insanity.
The paretic will crave and use alcohol in the earlier stages of his
malady. The victim of nervous syphilis is addicted to it, more es-
pecially in the later stages, when the nervous system becomes in-
volved.
Any depressing, exhausting, or painful disease may produce the
alcoholic craving, alcohol being sought for its stimulating properties.
194
DISEASES OF THE BRAIN AND NERVES.
Alcohol, moreover, is second only to opium, ether, or ehloroforra
as an anaesthetic ; indeed, has been used as a substitute for the latter.
Hence, persons find experimentally that alcohol relieves pain, and
its use is carried to a harmful extent, its deleterious effects produced,
and inebriety established.
It is possible that a healthy individual, with good personal and
family history, may use alcohol sociably or as a matter of custom, un-
til the habit becomes firmly established.
The alcohol breaks down the constitution, invades and degenerates
the nervous system, and thus develops inebriety, because the alcoho-
lic degenerations, or even functional disturbances of the nervous sys-
tem, are the very conditions under which inebriety is established.
We say this is possible, but we assert again that behind the large
majority of inebriates will be found a defective family or personal
history, not only complicating but causing the inebriety ; retarding,
oftentimes preventing a cure.
It can be thus seen that inebriety is but a symptom — a flag of
distress hung out by the nervous system. As some one has aptly
said, “ neuralgia is the cry of a diseased nerve,” so the “ drink-craze ”
is the cry of the neurasthenic for a stimulant, of the pain-tortured
nerve for an anaesthetic, of the victim of insomnia for a hypnotic.
Not any patient that applies for relief to the physician needs a
more careful examination than does the inebriate. You may rest as-
sured that there is some underlying cause, probably several that must
be removed if we would restore the inebriate to his former habits of
sobriety. If he is found suffering from the later manifestations of
syphilis he will need special treatment for this condition, especially
if the nervous system is involved ; a painful stricture of the urethra
may require division.
Chronic malarial poisoning with its complicating disorder of stom-
ach, liver and spleen, will demand special treatment. In a case on
record the irritation of a tape-worm produced a tendency to the ex-
cessive use of alcohol, winch tendency passed away when the worm
was expelled.
In a word, a large majority of inebriates are diseased persons, and
that primarily and antecedent to their inebriety, which is appended
to and aggravates their diseased condition.
Special diseases, therefore, require special treatment, irrespective
of the inebriety, if we would cure the inebriate. In this connection
we may ask, are there any drugs that we can substitute for alcohol
that will take its place, and satisfy the inebriate, as a substitute for
alcohol ?
Opium and the salts of morphia will do so in a marked degree, al-
though cocaine, chloral and the bromides have been so used.
The use of opium or morphia is not uncommon among inebriates
who desire to “ leave off alcohol.” The inebriate, as a rule, is a con-
genital neurotic. From birth almost, he reaches out for some drug
that will gratify or meet his neurotic craving. The alcohol and the
ACTUAL EFFECTS OF ALCOHOLIC LIQUORS ON THE
HUMAN STOMACH AND KIDNEYS
THE KIDNEYS
HEALTHY CONDITION DISEASED FROM INTEMPERANCE
THE STOMACH
HEALTHY CONDITION
DISEASED FFLOM INTEMPERANCE
DISEASES OF THE BRAIN AND NERVES.
195
opium nabit to the inebriate are convertible habits, and the inebriate,
like a pendulum, will swing from alcohol to opium ; not infrequently
the two habits are combined, as in the form of tinct. opii, constitut-
ing a mixed habit, in which the effects of both alcohol and opium
have to be considered. Occasionally a case is presented in which
morphia is used hypodermically, and the alcohol used in the usual
manner. In cases where opium addiction is associated with the habi-
ttial use of alcohol, the opium habit is of paramount importance and
the alcohol assumes a secondary place.
The fact that opium can substitute alcohol is the keynote to many
vaunted secret cures, in the so-called “ narcotic treatment ” for alco-
hol. It simply substitutes one habit for another, and as long as the
victim is taking the so-called remedy he is reasonably comfortable.
But I admit if the “ narcotic treatment ” was carefully practiced, in
judicious hands it might, in conjunction with such other remedial
measures as would best eradicate the primal causes of the inebriety,
prove useful, if not curative, in cases of inebriety.
Are there any drugs that are specifically beneficial for the treatment
of inebriety as such ? We would state that drugs that act directly as
a stimulant to the nervous system are of value. Strychnia is a type
of this class of drugs, and one of the best of it class.
Luton, of Rheims, Belgium, was the first to point out its value in
alcoholism. Then the Russians used it largely and it was known as
the “ Russian treatment,” and finally, the Americans adopted its use
in such cases.
Strychnia has proved serviceable as both abortive and curative in
acute alcoholic delirium, as well as useful in the more chronic forms
of alcoholism. It seems to be tolerated in such cases — in cases of
alcoholic poisoning under normal conditions, we have no record of
the value of strychnia as an antidote ; interesting experiments might
be made on the lower animals with the view of determining this
point. Strychnia is an excellent cardiac tonic, and one of the best
respiratory stimulants, and might be used in general medicine in
cases in which alcohol is oftentimes prescribed.
Oxide of zinc, during the past twenty years, has been used with
advantage in cases of chronic alcoholic intoxication.
Quinine has been used more particularly in the later or convales-
cent period of the treatment of alcoholism.
The so-called “ Red Cinchona Cure ” for a time interested the pub-
lic. Rational medicine does not recognize any special drug or speci-
fic remedy as a universal cure for inebriety, nor does clinical experi-
ence form any basis for such a claim. From the very nature of the
case, such a remedy would be impossible. The aetiology of inebriety
is dependent on such a variety of causes and its environments and
complications so numerous that any one remedy could not fulfill all,
or even meet the more important of these conditions. However val-
uable drugs may be to meet certain indications in the various condi-
tions incident to inebriety, we believe that so far as the curative
196
DISEASES OF THE BRAIN AND NERVES.
treatment of inebriety is concerned, drugs must assume a secondary
place, valuable as they may be in their respective spheres.
In the treatment of the alcohol habit we place first: Restraint and
seclusion in a special asylum for a definite period, and total abstinence
during this period.
In a few words, concisely expressed, this statement includes the
plan now adopted by the leading asylums of this country and of
Europe for the recovery of the inebriate. It involves restraint,
(legal, if need be), seclusion, a special institution, in which all the
latest and best methods of dealing with the inebriate are procurable,
a sufficient period in which to apply these measures, and we need
hardly add, a long period of total abstinence from all alcoholic liquors.
W e need hardly add that diet, rest, recreation, hygienic surroun^ngs,
and the exhibition of appropriate drugs are all included in the above
plan.
The causes of degeneration being removed, the factors of regenera-
tion being brought into action, new formation of nerve, muscle and
tissue must supplant degenerated tissue, if haply organic disease has
not resulted in irreparable injury.
We have liinted at an hysterical element in the history of inebriety.
The inebriate, whatever may be his condition, is largely influenced
by liis surroundings.
In the light of such an hysterical element in the clinical history of
inebriety, we can readily account for the apparent success of the so-
called temperance movements that sweep over communities periodi-
cally and effect many apparent cures, or rather, in the language of
the day, reformations. Such an element will also explain why, after
such a tidal wave of excitement, relapses take place oftentimes in
large numbers, and the period of excitement is followed by a period
of reaction.
The occurrence of relapses is readily accounted for by the fact that
the stimulus of the period of excitement buoys up the inebriate for
the time being, during which strong mental emotion is a powerful
factor. He is keyed up, as it were, for the time, and sustained by a
moral stimulus. When this is withdrawn, reaction, followed by cor-
responding depression, sets in, and the old method of stimulation is
again imperatively demanded and yielded to.
Why some inebriates go through such a period of excitement and
do not relapse, and why others do, can be accounted for by the fact
that the former are in a reasonable degree of physical health, and are
not burdened, dragged down and handicapped, either by disease that
is non-alcoholic, or that is the result of alcoholic degeneration. The
inebriates so affected are not influenced, or if at all, only temporarily,
by the so-called “temperance revivals” that appear and disappear
with almost stated regularity in large and small communities, and we
must add do good, but only in the channel indicated.
It is also operating through this hysterical feature of inebriety
DISEASES OF THE BRAIN AND NERVES.
197
that charlatanism may effect a temporary, possibly a permanent suc-
cess in a certain class of cases.
In cases where the hysterical element largely preponderates, we be-
lieve psycho-therapeutical agencies, or even those that appeal to
purely mental conditions, will be of service, but they will not cure a
cirrhosed liver, lung, or kidney, or remove the physical causes upon
which the inebriety may depend. In addition to those measures that
appeal to the higher moral nature, there ought also to be combined
such as meet certain intelligent wants. To this end all reasonable
amusements, entertainments, and especially such occupations as will
interest the person and keep him busy, should be encouraged, if not
made compulsory.
Incidentally I may mention hj-pnotism as having been used espe-
cially by French physicians, with some benefit in cases of chronic al-
coholism. I have no data to give, and have not had any personal
experience with it.
The Bi-Chloride of Gold cure, known as the Keeley cure, is in
many cases successful, but not in all. Would advise its use as a last
resort ; though we think its use sometimes leads to insanity and
suicide. It cures at all events for the time being.
If the temperance advocates would supply light, warm, cheerful
places of resort with hot and temperance drinks, supplied with pool
and billiard tables where the poor could spend their evenings and
meet each other and amuse themselves at a reasonable expense, and
establish cooking schools for the wives where they could learn how
to cook nourishing and palatable food which would supply the body
with the nourishment which it must have and requires, we believe
it would do more towards temperance than all the laws that could
be passed.
Many prominent physicians who have made alcoholism a specialty,
strongly recommend the immediate withdrawal of all liquors, and
isolation from all company where habits and influence would lead to
temptation, taking the following prescription faithfully for three or
four months:
Sulphate of magnesia .... one teaspoonful.
Nitric acid ...... “ “
Sulphate of iron ..... “ “
Powdered cinnamon ..... “ “
Sugar of milk ...... three teaspoonfuls.
Distilled water enough to fill a six ounce bottle.
One teaspoonful frequently when the crave is on, and in a wine-
glassful of water.
Cold sponge bath also should be taken once or twice a day.
Enlargement of the Brain. — Hypertrophy.
This is chiefly a disease of childhood. It consists in an unnatural
growth of the brain. Sometimes the skull grows with it, and there
may not be any, or only sHght, S3rmptoms of disease.
198
DISEASES OF THE BRAIN AND NERVES.
The complaint is sometimes congenital, — the child being born
with a head far above the natural standard of size. Sometimes a
child’s head, from this disease, will reach the size of an adult’s by
the time it is five or six years old. This is not necessarily a disease,
though children that suffer from it are very apt to die finally of some
affection of the brain.
Symptoms. — Dullness of intellect, indifference to external objects
great irritability of temper, inordinate appetite, giddiness, and an ha-
bitual headache, which at times is very severe. In addition to these,
there are, at times, convulsions, epileptic fits, and idiocy. There is a
peculiar projection of the parietal bones, which serves well to distin-
guish this disease from acute hydrocephalus.
Treatment. — As far as possible, suspend and repress all exercise
of the mind. Take the child from school as soon as the disease is
discovered, and put it to the most active muscular exercise in the
open air. The moment there is any excitement of the brain, or heat
on the top of the head, apply cold water, ice, or cold evaporating
lotions. If, as the child grows up, the signs of mischief increase, the
diet must be simple, and carefully regulated. Bread and milk only
is sometimes advisable.
Shrinking of the Brain. — Atrophy.
This is a disease in wliich the volume of the brain is diminished.
There are two forms of it ; one is congenital, the brain not being
properly developed at birth ; the other occurs in consequence of dis-
ease either in the membranes or the arteries. The symptoms are not
distinguishable during life from those of other brain affections, and
therefore it can only be treated according to general principles.
Water in the Head. — Acute Hydrocephalus.
This, like enlargement of the brain, is likewise a disease of child-
hood, and often attacks scrofulous children.
Being an inflammatory disease, it is important to have early notice
of its existence, and, if possible, to be aware of its approach ; which
we may be, frequently, by observing the following premonitory
Symptoms ; namely, a disturbance of the digestive functions, indi-
cated by a capricious appetite, — the food at one time being disliked,
at another devoured greedily; a foul tongue, offensive breath, enlarged
and sometimes tender belly, torpid bowels, stools light-colored from
having no bile, or dark from vitiated bile, fetid, sour-smelling, slimy
and lumpy. The child loses its healthy look, and grows paler and
thinner. Its customary spirit and activity are gone ; it is heavy, lan-
guid, dejected ; it is fretful, irritable, uneasy ; and sometimes is a lit-
tle tottering in its gait.
After these warning symptoms, the disease may begin in one of
three ways : —
DISEASES OF THE BRAIN AND NERVES.
199
The pains in the head become more severe and frequent, and are
sharp and shooting, causing the little patient to wake and shriek out.
As the drowsy state advances, the shrieking gives place to moaning.
Beside these symptopis, there are stiffness in the back of the neck,
pain in the limbs, great tenderness of the scalp, vomiting, sighing,
intolerance of light, knitting of the brows, increased disturbance of
stomach and bowels. This stage may last ten to fourteen days, the
child growing more weak and peevish.
Another form of attack is marked by acute pain in the head and
high fever, convulsions, flushed face, brilliant eyes, intolerance of light
and sound, pain and tenderness in the belly, stupor, great irritability
of stomach, causing retching and vomiting upon every attempt to sit
up in bed.
The third mode of attack is very insidious, — the early symptoms
being mild and hardly noticeable, or not even occurring at all. In
such case, the convulsions or palsy come suddenly, without notice,
bringing swift and unexpected destruction. This has sometimes been
called water-stroke.
The First Stage is the period of increased sensibility and excite'
raent, caused by inflammation, in which the pulse is quick and irreg-
ular.
The Second Stage is one of diminished sensibility, or lethargy, dur
ing which water is effused upon the brain, and the pulse is slow.
The Third Period is one of palsy and convulsions, with squinting
of the eyes, rolling of the head, stupor, and a rapid, thread-like pulse.
Treatment. — The first or inflammatory stage of the fever is very
important, and must be controlled for five or six days. Scammony and
croton oil (33) may be chosen for this purpose. Apply cold water,
ice, etc., to the head. Use tinct. veratrum viride or (355).
In the second stage, put blisters upon the back of the neck, and one
upon the bowels if they are very tender.
In the third stage, effusion having taken place, use the warm bath,
or the vapor bath, . — ■ also digitalis, squills, and iodide of potassium,
(144), (128), (302), (130). The effusion, if permanent, may be
drawn off.
Confine the child to a darkened room, of moderate temperature, —
excluding all noise and causes of excitement, and let him lie upon a
hair mattress, with his head somewhat elevated.
Diet. — Gruel only during the stage of excitement, — during that
of collapse, it should be nourishing, but mild and easy of digestion,
as beef tea, plain chicken or mutton broth, and animal jellies. At
the same time, support the patient by the cautious use of the aromatic
spirit of ammonia, ten drops every four hours, valerian, wine whey,
and infusion of gentian, columbo, or quassia, (64), (66).
200
DISEASES OF THE BRAIN AND NERVES.
Dropsy of the Brain. — Chronic Hydrocephalus.
Acute hydrocephalus is an inflammation; chronic hydrocephalus,
now to be considered, is a dropsy. It often begins before birth. It
consists in the accumulation of enormous quantities of water within
the brain, sometimes within its ventricles, at other times upon its
surface. When it occurs soon after birth, it advances slowly and
imperceptibly, — the enlargement of the head being the first thing
noticed.
The skull being tender in infancy, it separates at the fontanelies,
as the fluid accumulates, and the head, at times, attains an enormous
size, — so great that the child cannot carry it upright, but lets it droop
laterally upon the shoulder, or forward upon the breast.
As the disease advances, the senses become blunted, the child is
deaf or blind, the intellect is weakened, perhaps idiocy appears, the
flesh and strength pass away, convulsions and paralysis come in their
turn, and a stupor is apt to occur which ends in death.
Treatment. — The remedies may be external, or internal, or both.
Internal Remedies. — These should be purgatives (33), (31), or
diuretics and alteratives (302), (145), (144).
External Remedies. — Apply an ointment of the iodide of potas-
sium to the scalp every night (185). A tight bandage applied over
the whole head will sometimes have a favorable effect. Another ex-
pedient is to puncture the skull and draw off the water. Tapping
the brain has effected a cure in many cases, and perhaps promises the
most relief of any remedy we have. In newly-born children with this
affection, it is the best means.
As may be expected, none of these remedies are likely to give ,
the benefit desired, and an operative interference above proposed
constitutes a risk which it is perhaps better to run even if it results
in the death of the child, rather than have it become a hopeless
invalid with epileptic convulsions and the other manifestations of an
impaired brain.
Cerebro=Spinal Fever.
Definition. —This disease may be contracted by poisoned air and
through the medium of fluids, and though markedly infectious, is not
supposed to be contagious. The other names are spotted fever or
cerebro-spinal meningitis. The disease is found among children and
young adults more often than among the aged. It occurs suddenly
in epidemics which cover a large territory and it does not appear to
be referable to any known laws or atmospheric conditions. The
death rate is exceeding high considering the number that have the
disease, and this rate varies during different epidemics although there
are different forms of severity.
DISEASES OE THE BEAlN AND NERVES.
201
Symptoms. — ^As a general rule the first symptoms are intense
headache with pain in the back of the neck or through the extremi-
ties and chest, followed by a moderate fever without sweating. Vom-
iting, and delirium with convulsions are common symptoms. In
a small portion of the cases, under fifty per cent, an eruption occurs,
which gives the name of Spotted Fever to the disease. The bending
back of the head on the neck making it impossible to bring the head
forward is known as retraction of the head and is a very common
symptom. Deafness, blindness and other complications are the re-
sult of irritation of the nervous system. The disease may he mistaken
for typhoid fever early in its course, though the bowel symptoms in
the latter disease are much more prominent.
Herpes or cold sores on the nose and lips are common in meningitis
and very rare in typhoid.
Treatment. — Cold to the head by means of ice bag should be at
once resorted to. The diet should be light and sedatives such as the
bromide of soda or chloral in 20 grain doses by the mouth and even
morphia in one-fomth grain doses will be needed to relieve and quiet
the nervous irritation.
Diseases of the Spinal Cord.
There are few diseases more interesting, as a study,
than those which affect the nervous cord which runs
through the centre of the back-bone. This cord is a
continuation, an appendage or tail of the brain. (See
Figure 84.) It is the seat and centre of certain ner-
vous functions, called reflex, by which so many move-
ments take place which are not under the control of the
will.
In order that we may feel what takes place in any
part of the body or limbs, and that the will may have
power to move such part, it is necessary that nervous
matter should be continuous and unbroken between the
part in question and the brain.
If the spinal cord be cut, broken, or crushed at any
point, all those parts which receive nerves from below
the injury, lose their power of motion and their feel-
ing. When the injury is in the upper part of the cord,
the breathing and the circulation will stop, and death
is the immediate consequence. If the middle portion
of the cord be the seat of the injury, the bowels and
other organs may lose their motion and feeling ; if the
lower portion, then the lower limbs only will be the
sufferers.
Fig. 84, Disease or injury in the upper part of the cord is
therefore much more dangerous than the same thing
occurring in the lower.
202
DISEASES OF THE BRAIN AND NERVES.
Inflammation of the 5pinal Cord.
The membranes wHch surround the cord may be inflamed just as
those are which enclose the brain ; but as the cavity running through
the spine is quite small, there cannot very well be inflammation of
the membranes without its involving the cord at the same time.
Symptoms. — Pains, often intense, running along the spine, extend-
ing out into the limbs, and made worse by motion. They are similar,
in some respects, to rheumatic pains. There is rigid contraction, and
sometimes violent spasms of the muscles of the back and neck, — so
great, at times, as to bend the body back into the shape of a hoop ;
also a feeling of constriction in various parts, as if they were girt by
a tight string; a sense of suffocation; retention of urine; a most
obstinate constipation and frequent chills or rigors. The pain which
is felt along the cord is aggravated by rapping upon the spine, but
not by pressure.
The above symptoms are supposed to be the result of inflammation
predominating in the membranes. When its seat is more particularly
in the substance of the cord, the symptoms are, — convulsive affec-
tions of the head and face, inarticulate speech, loss of voice, squint-
ing, and difficulty of swallowing, if the extreme upper part of the
cord is inflamed; if the disease be slightly lower, difficulty of breath-
ing, irregular actiou of the heart, and tightness of the chest; if lower
still, vomiting, pain in the belly, sensation of a cord tied round the
abdomen, pain and heat in passing water, retention of the urine, ina-
bility to retain the urine, desire to go to stool, or involuntary stools.
Spasm and stiffness, then, are the results of inflammation of the
membranes ; convulsions and palsy, of the same affection of the cord.
Treatment. — When the inflammation is acute, apply a few leeches
or wet cups along the sides of the spine. In chronic inflammation,
powerful fi'iction, or mustard draughts, stimulating liniments (190),
or plasters, will generally answer the purpose.
Apoplexy.
Apoplexy is that condition in which all the functions of animal
life are suddenly stopped, except the pulse and the breathing ; — in
which there is neither thought, nor feeling, nor voluntary motion ; in
which the person falls down suddenly, and lies as if in a deep sleep.
Modes of Attack; — There are at least three ways in which this ter-
rible disease may make its assault.
The First form of attack is a sudden falling down into a state of
insensibility and apparently profound sleep, — the face being gen-
erally flushed, the breathing stertorous or snoring, the pulse full and
not frequent, with occasional convulsions-
DISEASES OF THE BRAIN AND NERVES.
203
From this mode of attack some die immediately, others get entiiely
well, and others get off with the exception of paralysis on one side,
or the loss of speech, or some one of the senses.
The Second form of attack begins with sudden pain in the head.
The patient becomes pale, faint, sick, and vomits, — has a cold skin
and feeble pulse, and occasionally some convulsions. He may fall
down, or may be only a little confused, but will soon recover from all
the symptoms, except the headache, — this will continue, and the pa-
tient will sooner or later become heavy, forgetful, unable to connect
ideas, and finally sink into insensibility, from which he never rises.
This mode of invasion, though not appearing so frightful as the
first, is of much more serious import.
In the Third form of attack there is sudden loss of power on one
side of the body, and also of speech, but not of consciousness. The
patient retains his mind, and answers questions either by words or
signs. This may he called paralytic apoplexy. The patient may
either die soon, or get well, or live for years with imperfect speech,
or a leg dragging after him, or an arm hanging useless at his side.
The Persons Attacked are apt to have large heads, red faces, short
and thick necks, and a short, stout, square build, though it occurs
often among those who are thin, pale, and tall. The tendency to it
increases in advanced life.
The Forerunners of apoplexy are headache, vertigo, slight attacks
of palsy, double vision or seeing two objects when there is but one,
faltering speech, inability to remember certain words, sometimes a
sudden forgetfulness of one’s own name, a frequent losing of the
thread of ideas attempted to be pursued, and occasionally an unac-
countable dread, for which no reason can be given.
Exciting Causes. — Whatever hurries the circulation of the blood,
as strong bodily exercise, is an exciting cause. So are all those things
which cause the blood to flow towards the head, as coughing, sneez-
ing, laughing and crying, straining at stool when costive, lifting heavy
weights, singing, and playing on wind instruments. To these may
be added, exposure to the sun, the bad air of crowded rooms, holding
the head down, or turning it around to look backward, tight cravats
worn about the neck, and exposure to severe cold.
Treatment. — If the patient have the appearance of suffering from
fulness of blood in the head, as evinced by redness and turgescence
of the face and throbbing of the temporal arteries, and if the pulse
be full and hard, feeling like a tense vibrating rope under the finger,
place him in a half-recumbent posture, with his head raised ; loosen
his clothes, particularly his neck-cloth and shirt collar, and whatever
may press upon the neck, and then as quickly as possible apply cold
wet cloths to his head, changing them often. Ice is still better, if
204
DISEASES OF THE BRAIN AND NERVES.
may be had. Apply wet cups to the nape of the neck, and mustard
draughts to the soles of the feet. — at the same time applying tight
ligatures around the limbs, to prevent the blood from returning
rapidly in the veins. The ligatures should be gradually removed
when the patient recovers his consciousness. Also administer a
stimulating, purgative injection (246), and place two drops of croton
oil, rubbed up with a little pulverized loaf sugar, far back upon the
tongue. Repeat the injection every fifteen minutes, till the bowels
are thoroughly moved. This is one of the few diseases suitable for
bleeding.
If the patient be old, and the pulse small and feeble, with no ful-
ness or beating of the temporal arteries, or swelling of the veins of
the neck and forehead, the countenance being pinched, and the skin
bloodless and cold, the cupping, purging, and applying the ligature
must be omitted. In this case it will be better to apply warm
flannels and hot bricks to the surface, and administer ammonia
and camphor (283), (135) internally.
To prevent future attacks, gentle tonics should be used, and the
skin should be kept healthy by daily bathing and friction. The
bowels must not be permitted to become costive. The diet should
be light, chiefly vegetable, and almost entirely , so in hot weather.
The food should be well chewed. The mind should be kept cheer-
ful and hopeful, and free from great excitement. The sexual
passion should be restrained, and very rarely indulged. Intoxicating
drinks should be abandoned, if used, and all tight cravats be dis-
carded from the neck. Direct rays of the hot sun in summer should
be carefully shunned. No food should be taken for three hours
before retiring, and a mattress only, of some degree of hardness,
should be slept upon, — the head being always well elevated. To
these precautions, I would add dipping the feet every night before
retiring in cold water; and, if any tendency to cold feet be ex-
perienced, dusting pulverized cayenne in the bottoms of the
stockings.
Sunstroke. — Coup de Soldi.
Sunstroke results from the exposure of the body to excessive heat
in the form of high temperature either of the sun’s heat, from a fur-
nace, or an exceedingly hot day from heat without direct exposure
from the sun. There are two varieties, one known as heat exhaus-
tion, where the temperature of the person’s body is only slightly
elevated, if at all, the other, and the more common one “heat stroke”
or “sun stroke” in which the temperature of the body is raised many
degrees. The symptoms are headache, dizziness and sometimes diffi-
cult breathing and thirst in the earlier stages, which if not recognized
and means taken to prevent more serious troubles, at once go into
unconsciousness, possibly accompanied by convulsions and spasms.
If the fever cannot be reduced a serious condition occurs, followed
probably by death inside of twenty-four hours. Even an improve-
DISEASES OF THE BRAIN AND NERVES.
205
ment may be followed later by a fatal meningitis. Persons who
have once had sunstroke are also greatly afflicted by high tempera-
tures which is intensified if the air is moist. It is needless to add
a large portion of these cases die.
Treatment. — As is known the normal temperature is 98 J degrees
and the bath is used to reduce the temperature as near this as possible.
Strip the patient, lay him flat on the floor or low bed and if possible
apply ice; ice water or even a stream of cold water from a hose may
be applied over the body, but the circulation must be kept up by an
attendant rubbing the surface of the body to produce reaction so
that the cooling of the body will be general and not entirely on the
surface, as the congestion of the body with heated blood which
would be caused if the rubbing was omitted would kill the patient.
Ice should be applied to the head by means of an ice bag or some
other means. Constant care should be taken that these measures
while strenuous, should not be carried too far when the temperature
once begins to drop, as when once started the patient immediately
goes into collapse from the fever dropping too rapidly. Heart stimu-
lants such as teaspoonful of aromatic spirits of ammonia with twenty
drops of compound spirits of ether or strychnia in one-thirtieth
grain doses may be given to support the heart. Alcohol should be
avoided as it will only increase the congestion in the head; some
good cathartic, as citrate of magnesia, should be given and the head-
ache which often follows may be relieved by a twenty-grain dose of
bromide with five grains of phenacetine added; the recurrence of
high temperature should be watched for as it very often occurs, when
cold baths will be again required, as a relapse is not at all uncommon.
Palsy. — Paralysis.
Palsy is a loss of the power of voluntary motion and feeling, one
or both coming on, sometimes gradually, but more often suddenly,
and extending at one time to a part, at another time to the whole
body. It is a kind of station-house on the way to apoplexy, where
passengers stop, not merely to stay over night, but to rest many days,
or even years.
A great injury inflicted upon the brain, either by pressure or other
cause, will induce a complete loss of motion and feeling, and this ex-
tending to the whole structure, brings likewise a loss of conscious-
ness, which is apoplexy. A smaller degree of pressure, or a less
injury upon the same brain, would occasion a loss of motion only,' or,
if a loss of feeling were experienced also, it would only extend to a
part of the body, and consciousness would remain. This would be
palsy. The disease is like apoplexy in kind, but stops short of it in
degree.
206
DISEASES OF THE BRAIN AND NERVES.
Paralysis of One Side of the Body. — Hemiplegia.
When palsy affects an entire half of the body, dividing, it through
the centre of the face, neck, body, etc., from head to foot, it is called
hemiphlegia. It is more nearly allied to apoplexy than any other
form of the disease, and is generally ushered in by pretty well-marked
apoplectic symptoms.
Symptoms. — Sometimes there are no premonitory symptoms ; but
often before the attack there are flushed face, swelling of the veins
about the head and neck, vertigo, a sense of fullness, weight, and
sometimes pain in the head, ringing in the ears, drowsiness, indistinct
articulation of words, or even loss of speech, confusion of mind, loss
of memory, and change of disposition, — amiable persons being made
sullen and peevish, and irritable ones mild and simpering. After
the attack, the countenance generally acquires a vague expression ;
the mouth is drawn to one side ; the lower lip on the palsied side
hangs down, and the spittle dribbles away. The speech is altered,
and the mind is generally impaired.
In some instances, the patient recovers in a longer or shorter time ;
in others, little or no improvement takes place, and the patient, after
remaining helpless, often for a long time, dies either from gradual
exhaustion, or suddenly from apoplexy.
Causes. — Hemiphlegia and paraphlegia are caused by pressure
upon the brain, by the effusion upon it of blood or water, by a tumor,
by mechanical injuries, by the striking in of eruptions, and by intem-
perance in eating and drinking. Paraphlegia often results from dis-
ease or injury of the spinal marrow.
Treatment. — In so many cases does the administration of iodide of
potash give greater or less relief to different diseases of the brain
resulting in paralysis that its use is recommended. It must be per-
sisted in for weeks and months. The doses need not be excessive,
and five to ten grains in a half glass of water or milk a day and
continued some time will often be followed by improvement. There
are other preparations of similar nature recommended from time to
time but all depend upon the amount of iodine which can be absorbed
by the system.
Paralysis of Lower Part of Body. — Paraplegia.
This form of palsy divides the body transversely., at the hips, and
confines itself to the lower extremities, and to the parts about the
pelvis.
Symptoms. — When it arises from affections of the brain, it is at-
tended by pain in the head, giddiness, drowsiness, dimness of sight.
DISEASES OF THE BRAIN AND NERVES.
207
and impaired memory. Numbness is sometimes felt in the upper ex-
tremities as a forerunner of this form of palsy. At first there is a
slight stiffness and awkwardness of the motion of the legs, which
continue to increase till a cane is needed to balance the body and
make it steady. From a paralysis of the neck of the bladder, the
stream of urine grows more feeble, and finally dribbles away involun-
tarily. The bowels are for a time costive, but when the circular
muscle which closes the fundament becomes palsied, the feces pass
■without consent of the will.
When disease of the spinal cord is the cause of the complaint, it
is apt to come on gradually ; languor and weakness are felt in the
knees, the legs are not easily directed in walking, — being thrown
across each other, causing tripping and stumbling. By degrees the
loss of power increases in the thighs and legs, until at length the
whole lower extremities become palsied and useless.
Local Palsy.
Palsy is called local when it is confined to a single limb, or muscle,
or locality. One of these forms is caMedi facial pals3^ It affects one
half the face only, and is a good specimen of these affections. It
removes all power of expression from one half of the face, and leaves
the features still, blank, and unmeaning. With the affected side of
the face, the patient cannot laugh, or weep, or frown, or express any
feeling or emotion, while the features of the other side are in full
play. Among the ignorant, who do not comprehend the extent of
the evil, the drollness of the expression excites laughter.
Shaking Palsy.
The nature of this form of palsy is well expressed by its name.
Symptoms. — The first symptom of this complaint is a weakness
and tremor of the head or hand. In about a year the other hand, or
the lower extremities become affected ; and the patient begins to lose
his balance in walking. Then the trembling becomes perpetual ; no
limb or part remains stiU.. Reading and writing are no longer possi-
ble, and the hand cannot even carry the food to the mouth. The
balance cannot be maintained in walking ; there is a tendency to fall
forwards, and to avoid it, the patient is obliged to run or move
quicker, and upon the toes.
At a later period, the tremor continues during sleep ; there is in-
creased weakness ; the body is bent forward, the speech becomes in-
distinct, swallowing difficult, and the bowels torpid. At last the
urine and feces pass involuntarily, and delirium and coma bring life
to a close.
208
DISEASES OF THE BRAIN AND NERVES.
Lead Palsy.
In this disease the muscles of the forearm are palsied, so that the
wrists “ drop,” as it is said, and the hands hang down when the arms
are stretched out. It is caused by the gradual introduction of lead
into the system. It is a disease, therefore, peculiar to painters, —
particularly those who use carbonate of lead, or white lead, as it is
called. It is generally the sequel of painter’s colic.
Treatment. — A sudden and severe attack of palsy requires the
same treatment as apoplexy. When the bowels are obstinately con-
stipated, they must be moved by scammony and croton oil (31), (32)
and by injections (246).
When all the symptoms of determination of blood to the head have
disappeared, and the disease has become strictly chronic, exciting
remedies must be employed, as frictions, stimulating liniments, blis-
ters, stimulating baths, cold affusion, and electricity. Among the in-
ternal remedies, strychnine has the best reputation (85), (86). The
tincture of the poison oak is well recommended (284). An altera-
tive (145) should likewise be used.
Apply counter-irritants along the track of the spine, such as blis-
ters, the moxa, the compound tar-plaster, and the pitch-plaster.
At first the diet should be light ; but after the more active symp-
toms have disappeared, it should be nutritious, and sometimes stimu-
lating. Flannel underclothes should always be worn next the skin.
For lead palsy, the best remedies are iodide of potassium, or sul-
phuret of potassium. The dose of either of these is from three to ten
grains, three times a day, dissolved in water, one ounce of the salt to
six ounces of water, and taken in simple syrup. The affected limb
should also be soaked an hour each day in a gallon of water, with
half an ounce of sulphuret of potassium dissolved in it.
Hydrophobia. — Rabies.
The bite of the mad dog, or mad wolf, or other hydrophobic ani-
mal, is the most dangerous of all poisoned wounds, because it is apt
to be followed by a disease for which there is no certain remedy.
Fortunately, the human subject is not as susceptible to the effects of
the poison as some of the lower animals ; for only about one-tenth of
those bitten are attacked by hydrophobia.
Symptoms. — The interval between the bite and the appearance of
the disease varies from twelve days to two months. The wound
heals like any other bite of a similar animal. After a time, the scar
begins to have darting, lancinating pains, which, if it be a limb that
was bitten, run up towards the body. Sometimes it feels cold, or
stiff, or numb, or becomes red, swelled, or livid, and occasionally
breaks open, and discharges matter. The patient feels a strange anx-
iety, is depressed in spirit, has an occasional chill, and disturbed
DISEASES OF THE BRAIN AND NERVES.
209
sleep, and spasmodic twitches. The pulse is above its natural state,
both in quickness and strength, and the nervous system is very im-
pressible. The senses are all more acute ; trifling noises produce
agitation, and the eyes are so disturbed by the light that the patient
sometimes hides himself in a dark place. The appetite is lost. This
is the first stage.
Thirst now appears, and he attempts to drink. But the moment
water approaches his mouth, a spasmodic shudder comes over him ;
he pushes it back with horror ; the awful fact of his condition flashes
upon him ; and he cries out, “ What I have dreaded has come upon
me.”
Thenceforward he can swallow no fluids ; complains of pain and
stiffness about his neck ; is thrown into convulsions by the sight of
water, or even the sound of liquids agitated in a vessel, or by a
breath of air blowing upon him, by a bright light, or by the glare of a
mirror. His throat is full of a viscid, glary matter, which he con-
tinually tries to clear away. Thus, between convulsions, in which
he struggles, and sometimes strives to bite his attendants, and com-
parative stillness, during which he suffers great depression of spirits,
he passes three or four days, and then dies either in a spasm, or from
exhaustion.
Treatment. — Immediate suction of the wound, with care being
taken that the person whose lips are used has no abrasion or wounds
there, followed by disinfection is certainly the best method, if resort
cannot be had to some of the institutions where Pasteur injective treat-
ment can be utilized. Disinfection may be carried out if the wound is
a torn one, not a narrow and deep one, or in the latter case it would
probably be better to cut away enough flesh so that the disinfectant
may reach the bottom of the wound. The use of corrosive sublimate
in the strength of one part to 500 of water applied to the wound for five
or ten minutes and then a poultice of weak solution of one part to 3,000
of water applied and bound on. The corrosive tablet sold at all drug
stores contains about 7 grains of poison, and dissolving one of these
in a half pint of water makes a strength of one to 500; a strength
1 to 1,000 may be made by dissolving one tablet in a pint of water.
Some of the Western physicians declare the red chickweed, or scar-
let pimpernell, to be an absolute remedy for this disease, and cite
some quite remarkable cases of its success. Four ounces of this
plant, in the dried state, are directed to be boiled in two quarts of
strong beer or ale, until the liquid is reduced one half. The liquid
is to be pressed out and strained, and two drams of laudanum added
to it. The dose for a grown person is a wine-glassful every morning
for three mornings. A larger dose is required if the disease have
begun to show itself ; and if the case be fully developed, the whole
may be taken in a day. The wound is to be bathed with the same
decoction. The medicine, it is said, produces profuse sweating. It
is worth a trial.
210
DISEASES OF THE BRAIN AND NERVES.
Considerable has been said of late of a remedy used in some parts
of Europe, and said to be effectual. It is the “ golden cenotides ”
(cetonia aurata), or common rose-beetle, found in large quantities on
all rose-trees. A similar insect is said to infest the geranium-plant.
When collected, they are dried and powdered ; and given in this
form, relieve excitement (so it is said) of the brain and nerves, and
throw the patient into a sound sleep.
Muscular and Nervous Derangements from
Wounds.
In some persons, a very small local injury will produce violent dis-
turbance of the nervous system. Some will faint and be thrown into
convulsions and vomiting from causes scarcely greater than the prick
of a needle ; and, before Morton gave the world the boon of ether, it
was not very uncommon for persons to die under the knife of the
surgeon. One of the most serious disturbances from wounds, of a
nervous and muscular character, is
Locked Jaw. — Tetanus.
This is spasmodic contraction, with rigidity, or stiffness, of the
voluntary muscles. Sometimes this rigidity is partial, at other times
universal throughout the system.
Tetanus is produced by two causes, exposure to cold (idiopathic),
and hodily injuries, particularly the injury of a nerve (traumatic te-
tanus). This last is the most frequent, — perhaps the only form of
the complaint.
The Symptoms are long-continued, violent and painful contraction
or cramp of the voluntary muscles. At first there is difficulty and
uneasiness in turning the head, with inability to open the mouth
easily, — then the jaws close gradually, but with great firmness ;
swallowing now becomes difficult, and a pain, starting from the
breastbone, pierces through to the back, — probably caused by cramp
of the diaphragm or midriff. The cramps now extend to the muscles
of the body, the limbs, the face, the tongue, etc., which continue in a
state of rigid spasm, — being swelled and hard in the centre, — till
the disease yields, or the patient dies. At times the abdominal
muscles are so tense as to make the belly as hard as a board. Occa-
sionally the patient is drawn backward into the shape of a hoop, so
as to rest on his head and heels (episthotonos) ; at other times he is
drawn forward in the shape of a ball (^emprosthotonos) . All the con-
tractions are attended with intense pain. It is the racking of the en-
tire body with cramps like those which sometimes attack the calf of
the leg. So violent are the contractions that the teeth are sometimes
broken by them, and the tongue is often badly bitten. In the mean
DISEASES OF THE BRAIN AND NERVES.
211
time, the appearance of the sufferer is frightful. The forehead is
wrinkled, the brow knit, the eye-balls motionless and staring, the
nostrils spread, the corners of the mouth drawn back, the set teeth
exposed, and all the features fixed in a ghastly grin.
The prevention of tetanus can be accomplished by thorough disinfec-
tion of all wounds, especially those due to gun-powder accidents and
implements around stables and manure heaps.
In 1905 the number of cases reported following the July 4th cel-
ebration was 75 per cent, less than the previous year, owing to pre-
cautions taken. It is so fatal that somewhere about 70 and 80
per cent, of those who become affected die. The most valuable
treatment is the injection under the skin by a competent person
of the antitoxin of tetanus, but even this, to be successful, must be
administered within a short time after the wound is made to prevent
the poison from invading the nervous system and causing death.
Treatment. — At once upon the receipt of a wound which is sus-
picious the same treatment should be given as suggested for hydro-
phobia; on no account should the wound be closed over and allowed
to heal in the early stages. If the disinfectants are not available it
is much better to leave the wound exposed to the air, as the growth
of these germs which is the cause of the disease is increased by exclu-
sion of air. If the jaw becomes locked so that food cannot be taken,
it may be necessary to feed the patient by means of a small rubber
tube through the nostril or even the rectum, but a physician will,
of course, have charge of the procedure. Ether and chloroform in
desperate cases may be inhaled to ease the final struggle of the patient,
or bromide of soda and chloral in large doses will also be useful.
Epilepsy. — Epileptic Fits.
This disease has been sometimes called the falling sickness, but
generally passes under the more vague title of fits.
Symptoms. — The disease is characterized by a temporary loss of
consciousness, strong spasms and intervals between the fits. The at-
tack is sudden, generally without warning, and attended with a loud
cry, when the patient falls down, is senseless and convulsed, struggles
violently, breathes with embarrassment, has a turgid and livid face,
foams at the mouth, bites his tongue, has a choking in the windpipe,
and appears to be at the point of death. Presently, in from five
minutes to half an hour, and by degrees, these symptoms diminish,
and at length cease ; and the patient falls into an apparent sleep. In
a short time more he recovers, and is apparently well. These attacks
come again and again, and at irregular intervals.
This is the worst form of the disease ; there is another class of
cases in which the symptoms are much lighter, — there being no tur-
gescence of the face, no foaming at the mouth, no cry, no convul-
212
DISEASES OF THE BRAIN AND NERVES.
sions ; but merely a sudden and brief suspension of consciousness, a
fixed gaze, a feeling of confusion, or a totter, from all of which the
recovery is speedy.
Causes. — These are numerous, — as worms, disturbance from indi-
gestible food in the stomach and bowels, difficult teeth-cutting, ner-
vous irritation, either direct or by sympathy, sexual excesses and
masturbation, disease or injury of the brain or spinal marrow, gall
stones in the excretory duct of the liver, stone or gravel in the kid-
neys and bladder, fright, distress of mind, passion, great loss of blood,
and many others.
Treatment.— But little can be done during the fit, except to pro-
tect the patient from being injured by the violence of the convulsions
and especially for unusual accidents that may happen while the
victim is falling unconscious, such as burying the face in the pillow
at night, choking due to the food stopped in the throat or falling of
the body on hard substances causing breaking of the bones, even
fracture of the skull. There is little fear that death will result. Cures
are seldom obtained but the violence of the convulsions may be greatly
diminished by proper treatment and the time occurring between
attacks of greater length. The most important drug and the one
tried which has given the largest number of happy results is the bromide
of strontium, which drug as well as any chosen must be used over
a long period of time and even after the improvement has been
noticed. The use of the drug must be continued even over a matter
of years in the dosage of 10, 20 and even 30 grains well diluted with
water, three times a day, and in all probability an improvement may
be expected. If as in a certain proportion of cases an attack is pre-
ceded by a premonition of its onset, the inhalation of the vapor of
nitrite of amyl which can be purchased in pearls, and crushed in a
handkerchief, the attack can be prevented.
In all cases, indeed, the diet should be carefully regulated, being-
light, nutritious, and easy of digestion. The sleep should be taken
at regular hours, and daily exercise in the open air be insisted upon.
The bowels must be kept regular, by the food, if possible ; if not, by
mild laxatives. Apply along the spinal column 195, once a day, rul^
bing it well in ; also, now and then, mustard poultices.
In addition to these remedies, give pills of iron and quinine (72).
one after each meal, — also oxide of zinc (270), which is one of our
very best remedies. Of the pills, one should be taken three times a
day. Bromide of sodium, 1 dram in 24 hours, mostly at bedtime.
We can seldom go amiss in giving medicine calculated to relieve
nervous irritation, and to build up the general system. For this pur-
pose, the valerianate of quinine, and the extract of black cohosh (7 9)
are well adapted. Citrate of iron and strychnine (316), is a very val-
uable remedy.
It is said that a black silk handkerchief thrown over the face of a
DISEASES OF THE BEAIN AND NERVES. 213
person in a fit, will immediately bring them out of it. It is an ex-
periment easily tried ; and having seen it in a respectable medical
journal, I give it for what it is worth. The bromides in large doses,
long-continued, sometimes cure epilepsy (367).
Catalepsy. — Trance. — Ecstasy.
Cataleptic fits are simply what is known to all the world under
the name of trance; and ecstasy is a modification of the same nervous
disorder. It is a state in which the mind becomes so intensely ab-
sorbed in something outside of its earthly tenement, that it withdraws
all control over the body, and all apparent connection with it, leav-
ing it as if dead. There is a very light ticking of the heart, just per-
ceptible to a cultivated ear, but the breast does not rise and fall with
breathing, the features are all inexpressive and still, the eyes are wide
open and motionless, apparently staring after the departed intellect ;
and the body and limbs are entirely passive, — remaining unmoved
where they are placed by others, however tiresome and uncomfortable
the position. In a word, a person in catalepsy is, in appearance, like
a marble statue, or like a human body suddenly turned to stoDe, or,
like Lot’s wife, to a pillar of salt. There is as little feeling, oi*
thought, or consciousness, as if the bowl had been instantaneously
broken at the cistern, and the apparent death were real.
It is a peculiarity in this disease that the patient, on recovery
from a fit, takes up the thread of conscious life just where it was
broken by the attack. Thus, if she were lifting a cup^ of water to
the mouth, she would hold it steadily, with the mouth open, till the
return of consciousness, and then place it to the lips, as if no inter-
ruption had occurred ; or, if conversing, and in the midst of a sen-
tence, the unfinished words would be uttered at the end of the fit,
even though it should last many days.
Persons in a cataleptic fit have much the appearance of one in the
mesmeric state ; and the statue-like position in which an attack fixes
a patient, reminds one of the manner in which the psychologists, so
called, will arrest a man under their influence, and make him im-
movable, with one foot raised in the act of stepping.
The disease attacks females much more often than males.
The premonitory symptoms are much like those of epilepsy, and
the treatment should be about the same.
Saint Vitus’s Dance. — Chorea.
This disease is chiefly conflned to children and youth between the
ages of eight and fourteen. But few cases occur after puberty.
Symptoms. — The complaint affects mostly the muscles and the
limbs. It excites curious antics, — such as we should suppose would
occur if a part of the muscles of voluntary motion had hatched a
mimic rebellion, broken away from the control of the will, and in
214
DISEASES OF THE BRAIN AND NERVES.'"
sheer mischief and wantonness, were tripping their fellow muscles,
and playing tricks with the patient. A few of the muscles of the
face or limbs begin their mischievous pranks by slight twitches,
which, by degrees, become more energetic, and spread to other parts.
The face is twisted into all kinds of ridiculous contortions, as if the
patient were making mouths at somebody. The hands and arms do
not remain in one position for a moment. In attempting to carry
food to the mouth, the hand goes part way, and is jerked back, starte
again, and darts to one side, then to the other, then mouth ward
again ; and each movement is so quick, and nervous, and darting,
and diddling, that ten to one the food drops into the lap. If the at-
tempt be made to run out the tongue, it is snatched back with the
quickness of a serpent’s, and the jaws snap together like a fly-trap.
The lower limbs are in a state of perpetual diddle ; the feet shuffle
with wonderful diligence upon the floor, as if inspired with a cease-
less desire to dance.
It is supposed by some that the disease consists in a partial palsy
of a part of the muscles. The will in that case not being able to
control the palsied muscles, when it commands the others to move,
their action is not balanced, and they twitch the face and limbs into
all the capricious and fantastic shapes we witness.
Others, and probably with more truth, hold that the seat of the
disease is in the cerebellum or little brain. It is supposed to be one
of the functions of this organ to preside over and regulate the loco-
motion,— that it holds the office of chief engineer, and that its
duties are to keep the muscles in subjection to the will. The com-
bined and consenting action of several muscles is needed for every
movement. It is the business of the cerebellum to maintain this
oneness of purpose and action — to see that no muscle flinches so as
to disturb the harmony of the movement. When the cerebellum is
diseased, all is confusion, — just as the locomotive runs from the
track when the engineer is smitten with palsy.
The disease is not dangerous, but when it continues for many
years it is apt to weaken the mind, and it sometimes very nearly
destroys it.
Causes. — Whatever excites and weakens the nervous system, as
powerful emotions of the mind, overworking the mind, reading ex-
citing novels, eating too much meat, fright, striking in of eruptions,
self-pollution, etc.
Treatment. — In the first place, remove all causes of excitemait.
Take the patient from school, and require some sort of cheerful out-
door exercise, daily. Take away all books, and be careful not to do
anything to occasion anger or fear, or any kind of injurious excite-
ment. Apply spinal ice-bags gradually and regularly.
In the second place regulate the diet — making it more animal
and stimulating if it has been too low, and more vegetable and cool-
ing if it has been too high.
DISEASES OF THE BRAIH AND NERVES.
215
In the third place, if the above changes have not been sufficient
for the purpose, open and regulate the bowels with some gentle
physic (30), (34) for a few days.
Iron in the form of tincture of the chloride of iron, 10 drops
in water taken through a tube after meals, and arsenic in the form
of Fowler’s solution must be used for the ansemia, which is so often
present. This latter drug is a strong solution of arsenic and must be
used with great care, given in a dose for a young child 2 or 3 drops
well diluted with water three times a day, gradually increasing a
drop a day up to 8 to 10 drops three times a day, which is the maximum
amount; it is not safe to increase more. The danger of poisoning must
be looked for, such as a puffiness about the eyes and nose, or pains and
cramps in the stomach. They show that the patient is getting a
little more than is sufficient. The drug should then be cut down
about half and continued at the last amount or entirely stopped. If
there is a rheumatic history the salicylate of soda in 5 to 10 grain
doses three times a day must be used. Next to arsenic, sedatives,
such as bromide of soda or hyoscyamus or better than all the fluid
extract of cimicifuga in the doses of half a teaspoonful diluted with
water twice a day often proves a help.
To these remedies should be added the shower-bath, beginning
with tepid water, and making it a little colder every day. If the
shower-bath frightens the patient, or is not otherwise well borne, take
the sponge bath.
Chronic Chorea.
This can hardly be said to amount to a disease. It consists rather
in uncouth tricks, arising from some slight disorder of particular
muscles, and grown into a fixed habit, such as shaking of the head
every three to twenty seconds, repeated squinting of the eyes in con-
nection with a peculiar knitting of the eyebrows, wrinkling of the
nose, shrugging of the shoulders, lifting the ears up and down, or
even moving the whole scalp back and forth. These movements are
commonly made without a consciousness of it ; and generally there
is no power to suspend them without a painful effort which cannot
be easily continued.
No medical treatment is of any avail. These tricks can only be
corrected by great watchfulness and effort on the part of the person
suffering from them, and in many cases, not even by such means.
Cramps.
Cramp is experienced -n the calves of the legs, the thighs, the
stomach, the breast, the Avomb, etc. It is a A’ery painful, sudden, and
violent contraction of one or more muscles. The part is sometimes,
as the phrase is, “ drawn up into knots.” When it attacks the stom-
ach, it is a very dangerous affection. Women are subject to it about
the third or fourth month of pregnancy.
216
DISEASES OF THE BEAIN AND NERVES.
They occur more frequently at night as the result of over-fatigue
and indigestion during the day. These spasmodic contractions often
occur in the abdomen and are accompanied by diarrhoea due to indi-
gestion. Abdominal cramps are also a symptom of locomotor ataxia
and other spinal diseases. The cramp of swimming is often due to
an over-straining of some one group of muscles not hitherto much
used, the sudden fatigue causing cramp. They may be also of ner-
vous origin. Rheumatism is not infrequently the sole cause of pain-
ful musculax spasms.
Causes. — Drinking cold water when very hot and perspiring, ex-
posure to damp night air, debility, indigestible food, and excesses in
eating and drinking, and particularly over-straining the muscles.
Treatment. — Moderate the excessive labor and straining of the
muscles which produce the cramps. When an attack occurs in the
legs, tie a cord or handkerchief tight around the leg above the af-
fected muscle. This will generally produce instant relief. Also
briskly rub the parts with hot water, alcohol, ammonia, spirits of cam-
phor, paregoric, or laudanum.
When it occurs in the stomach, apply warm fomentations, or what
is better, a mustard paste (165). Take hot Jamaica ginger or neuro-
pathic drops. The bowels, if confined, should be opened with an in-
jection.
Cramps of the limbs which afflict women in the family way, can
only be mitigated, not cured, till after confinement. As a palliative,
high cranberry bark, scullcap, etc. (87), will be found useful.
Pain of the Nerves. — Neuralgia.
This disease affects one tissue only, — the nervous ; and has one
symptom, — ])ain.
In apoplexy., the nerves, rendered powerless and senseless by an ex-
ternal force, are like a man under a bank of earth which has slid
down upon him. In palsy, they are suddenly bereft of feeling and
motion by a blasting scourge within, — as one is smitten down hy a
pervasive charge from a magnetic battery. In epilepsy, the nerves
are grasped and for a time held senseless by an unseen power, in
which they struggle, as a man strives in the folds of the anaconda.
In catalepsy, they are suddenly stiffened into senseless strings, for
such automatic use as the bystander may, for the time, choose to
make of them. In chorea, they are set to dancing by an invisible ex-
hilaration, as a man is suddenly crazed by brandy.
In neuralgia, the nerves are neither crushed, nor collapsed, nor re-
strained for a time, nor stiffened, nor exhilarated. They simply have
their sense of feeling intensely exalted ; they are filled with pain.
The pain is generally of a peculiarly darting, piercing character. The
patient sometimes calls it tearing pain. It comes on in sudden par-
oxysms, with intervals of freedom between. The attacks are some-
DISEASES OF THE BRAIN AND NERVES, 217
times like an electric shock, and are so agonizing as to bring a tern*
porary loss of reason. Occasionally there is great tenderness of the
parts affected, and some fulness of the blood-vessels in the neighbor-
hood ; but generally the signs of inflammation are all absent, except
pain.
Neuralgic pains occur in almost every part of the system. One of
the most familiar forms of the disease is known under the name of
Tic Douloureux.
It occurs in those branches of the fifth pair of nerves which go to
the face. (See Fig. 85.) Sometimes
one, sometimes all of the three branches
are affected, but more often the middle
branch only. When the upper branch
is the seat of the disease, the pain is in
the forehead, the brow, the lid, and some-
times the ball of the eye. The eye is
generally closed during the pain, and
the skin of the forehead is wrinkled.
When the affection is in the middle
nerve, the pain is preceded by a prick-
ing sensation in the cheek, and twitch-
ing of the lower eyelid. Soon it spreads
in quick and piercing pangs over the
cheek, reaching the lower eyelid, the
sides of the nostrils, and the upper lip.
If in the lower branch, it sends its light-
ning shafts to the chin, the gums, the
tongue and even up the cheek to the ear.
Face-Ache. — There is a species of nervous pain called face-ache^
which does not quite amount to tic douloureux, but is nevertheless
very afflictive. It occurs principally in the jaw, which seems to be
filled with pain. No one spot seems to be more affected than another.
From the jaw the pain often goes to the whole head, but it has not
the stabbing intensity which generally characterizes neuralgia. It
often proceeds from defective teeth.
Hemicrania.
This is a neuralgic pain, confined to one side of the head, — gen-
erally the brow and forehead. Sickness of the stomach often attends
it, and in many cases it is periodical, — coming on at a certain hour
every day, and lasting a given time, and then passing away.
It may be caused by whatever debilitates the system, as hysterics,
suckling an infant too long, or low diet. In fever and ague districts
it is frequently produced by miasm. In many instances, the cause
cannot be discovered.
218
DISEASES OF THE BRAIN AND NERVES.
Sciatica.
This is a pain beginning at the hip, and following the course of
the sciatic nerve. Occasionally it is an inflammatory complaint ;
sometimes is connected with an affection of the kidney; but fre-
quently it is a purely neuralgic or nervous pain ; and I have there-
fore thought it best to place it here, with nervous diseases.
Besides the various forms of neuralgia now noticed, the disease
occurs, — sometimes with great severity, — in the female breast, in
the womb, in the stomach, in the bowels, in the thighs, in the knee,
and even in the feet. In many of these cases the disease is not where
the pain is felt, but in the brain or spinal marrow, and consequently
the true source of the complaint very often escapes detection. An
excellent Episcopal clergyman in Northern New York, the Bev. M.
B — — , with whom I studied Latin and Greek preparatory to college,
had a neuralgic pain in the knee so intense, persistent and exhausting,
that the limb had to be cut off at the thigh to save his life.
Treatment. — This must be as diversified as the causes of the dis-
ease. For a general B use 368.
For tic douloureux, and some other forms, give internally, valerian-
ate of ammonia (88); also 89, 90, 91, 92, 93, 316, and 84, as tonics.
For external use in tic douloureux, and other neuralgic affections,
the prescriptions 188, 196, 197, 198.
For the face-ache, above mentioned, muriate of ammonia (134), in
half dram doses, is a very valuable remedy.
When the disease is caused by miasm, and has a periodic character,
like ague, it must be treated with quinine (67), (79), and if there he
a low state of the blood, iron (72), (93) must be given at the same
time. The galvanic battery often acts like magic in neuralgia.
The shower-bath, exercise in the open air, and whatever else will
build up the general health, must be used according to circumstances.
Neuralgic pain of various kinds often yields readily to some one of
the many coal-tar products like phenanthrene, antikamnia and ammo-
nol: say 10 grains of either every two to four hours according to the
intensity of the pain. The last named product is quite harmless and
produces no numbness or faintness which is said to follow at times
the use of some of the others.
Avoid rich or fatty foods. Live on a plain nourishing diet. Take
exercise out of doors as much as possible.
Derangement of Mind. — Insanity.
Most writers on this disease have attempted a definition of it. I
have never seen one which suited me. Here is mine. Insanity is a
wrench of man's nature, which sets his intellectual and moral faculties
nwry in their relations with the external ivorld.
DISEASES OF THE BRAIN AND NERVES.
219
In a state of mental and moral health, he looks straight at the out-
ward world, and sees it as it is ; insanity gives him an angular con-
nection with it and he sees it as it is not; its objects have all changed
their relative places ; objects at the right in the panorama of life have
moved to the centre, or gone quite over to the left ; while things at
the top have gone to the bottom, and those in the lowest places have
taken the highest. With the thoroughly insane, the world has gone
bach to chaos.
These persons have their sensibility very much altered and per-
verted. Errors of the senses and illusions cheat them. In many
cases, they cannot read because the letters are mingled in a confused
mass. They often do not recognize their friends, and regard them
as strangers or enemies.
They become awkward in the mechanical use of their hands, and
their touch loses the power to correct the errors of the other senses.
Hence they are cheated in regard to the size, form, and thickness of
bodies.
They are haunted, at times, with smells which have no existence,
and they hear voices distinctly speaking to them from clouds, or from
trees ; and these voices have the familiar tones of a friend, relative,
or enemy.
The insane lose the power of comparing ideas. They associate
things the most unlike, and often in a ridiculous way.
They also lose the control of themselves, and come under the do-
minion of their passions ; and then they will do acts which they them-
selves disapprove. One of strict integrity, of unblemished morals, and
of excellent standing, becomes insane, and immediately steals what he
does not want, makes infamous proposals, and indecent gestures, and
is in every respect the opposite of his past self.
The insane often become averse to those who were previously
among the most dear to them. For acts of kindness, they repay
abuse. They fly from their best friends. This is the result of their
fear and jealousy ; for they are very cowardly and jealous. This alien-
ation from friends is almost a characteristic of insanity, and is one of
its saddest features. The moral affections are always disordered, per-
verted, or annihilated in insanity. So much is this a leading feature
of the disease, that it is only when the insane begin to recover their
moral affections, when they begin to wish to see their children and
friends, to fold them once more in their arms, and to enter the family
circle and renew its joys, that we can count upon any certain signs
of a cure.
The insane have a thousand strong fancies in regard to themselves.
One thinks himself inspired of God. and charged with the conversion
of the world ; while another, equally sincere, believes the devil has
entered into him, and that the pains of hell are already taking hold
of him, and he curses God, himself, and the universe. Still another
is the “ monarch of all he surveys,” and much more ; he governs the
220
DISEASES OF THE BRAIN AND NERVES.
world, and directs the stars. One has all knowledge, and affects to
teach the wisest. Another is proud, and withdraws from his fellows,
bidding them not to come into his presence without proper acts of
homage, — calling himself, it may be, a king.
There are five kinds of insanity. I will speak of each of them
briefly.
Melancholy. — Lypemania.
This is characterized by moroseness, fear, and prolonged sadness.
The melancholic person is lean and slender, with black hair, and a
pale and sallow countenance. His skin is brown or blackish, and
dry and scaly. His physiognomy has a fixed appearance, the muscles
of the face are drawn tight, the eyes are motionless, and directed to
one point, the look is askance and suspicious, and the general expres-
sion is one of sadness, fear, and terror. He desires to pass his days
in solitude and idleness. He walks as if aiming to shun some dan-
ger. His eye and ear are on the watch for evil.
These persons do not sleep much. They are kept awake by fear,
jealousy, and hallucinations. If their eyes close, they see phantoms
which terrify them.
Their secretions are disordered. The urine is either abundant and
clear, or scanty and muddy. They sometimes retain their urine for
days. One patient did not dare to make water lest he should drown
the world, but was finally persuaded to it by the assurance that he
would extinguish a fire which was devouring a city.
Insanity on One Subject. — Monomania.
This is a chronic affection of the brain, not attended by fever, and
characterized by a derangement of the intellect, the affections, or the
will, upon one subject only. The patient seizes upon a false princi-
ple, and draws from it injurious conclusions, which modify and change
his whole life and character. In other cases the intellect is sound,
but the affections and disposition being perverted, their acts are
strange and inconsistent. These they attempt to justify by plausible
reasoning.
Mania.
This is also a chronic affection of the brain, generally without
fever. The countenance of the maniac is sometimes flushed, at other
times pale. The hair is crisped ; the eyes injected, shining and hag-
gard. Maniacs dislike the light, and certain colors horrify them.
Their ears are sometimes very red, and are disturbed by a tingling,
and a rumbling sound. Noise excites and disturbs them. They suf-
fer from false sensations, illusions and hallucinations; and their ideas
come with great rapidity, and are confused and without order. , Their
DIBEA.SES OF THE BRAIN AND NERVES.
221
affections are in a state of turmoil, and their judgments are all erro-
neous.
Unlike the monomaniac, their delirium extends to all subjects.
Their entire intellect, affections and will, are a chaotic wreck.
Dementia.
Hebe is another chronic affection of the brain, without fever, in
which the sensibility, the intellect, and the will, are all weakened.
Demented persons have not the power to concentrate their minds on
anything, and can form no correct notions of objects. Their ideas
float after each other without connection or meaning. They speak
without any consciousness of what they are saying.
Many of them have lost their memory, or, like old persons, they
remember nothing recent, — forgetting in a moment what is just said
or done.
The demented have neither desires nor aversions ; neither hatred
nor love. To those once most dear to them, they are totally indif-
ferent. They meet friends long absent without emotion, and part
from their dearest ones without a pang. The events of life passing
around them awaken in them no interest, because they can connect
themselves neither with the past nor the future ; they have no remem-
brances nor hopes. Their brain is inactive ; it furnishes no ideas or
sensations. They are no longer active, but passive beings ; they de-
termine nothing, but yield themselves to the will of others.
They have a pale face, a dull eye, moistened with tears, an uncer-
tain look, and a physiognomy without expression. They sleep pro-
foundly, and for a long time, and have a voracious appetite.
Idiocy.
Idiocy is in the condition in which the intellectual faculties have
never been manifested. We are not to infer disease from it, any more
than we infer it in the lower animals from the absence of intellect.
In idiocy there is no mind, because the brain is not large enough
to be the organ of intelligence. It always dates back, therefore, to
the beginning of life. Everything about the idiot betrays a defective
organization. The demented person, the monomaniac, etc., once had
intelligence ; the idiot, never. They, in many cases, may be cured ;
he is hopelessly incurable. They had blessings which have been taken
from them ; to him, none were ever given. They were once the pride
and hope of their friends ; he, from his birth, was the smitten and
blasted one of his family. He never reaches an advanced age, —
rarely living beyond thirt3'‘ years. *
These remarks are sufficient to show the difference between idiocy
and other forms of mental derangement. In the other forms of in-
sanity there are brains enough, but they are diseased ; in this there is
no disease ; the smallness of the brain is the primal and fatal defect.
222
DISEASES OF THE BRAIN AND NERVES.
This form of mental derangement is caused by a defective develop-
ment of the brain. That the other forms are produced by disease of
the brain, there can be no doubt.
Some have supposed insanity to be a mental disorder merely, hav-
ing nothing to do with the body. They might as well suppose the
delirium of fever to be a disease of the mind only.
Insanity is an unsoundness of the brain and nerves which proceed
from it, in every instance. At first it is probably only excitement of
the brain ; but this, long continued, becomes a chronic inflammation.
The brain and nerves of an insane person are undoubtedly sore, and
hence the painful thoughts and feelings which afflict them. When
the soreness is much increased, they are violent and furious ; when
it subsides, they are calm. In consequence of this inflammation and
soreness of the brain, an insane person can no more think, or reason,
or will, or feel correctly, than a person with an inflamed stomach can
digest food well, or than one with inflamed eyes can see well.
Causes of Insanity. — Hereditary predisposition; painful subjects
of thought or feeling long revolved in the mind ; injured feelings
which cannot be resented, mortified pride, perplexity in business ;
disappointed affection or ambition ; great political, religious, or social
excitements ; sudden and heavy strokes of misfortune in the loss of
property and friends ; and in general, whatever worries the mind for
a long time, and creates a deep distress, may be a cause of insanity.
But one of the most prolific causes, and worthy of special mention,
is masturbation, or self-pollution, — a vice contracted by thousands of
young people, both male and female.
Besides the above, I may mention several physical causes, as con-
vulsions of the mother during gestation, epilepsy, monthly disorders
of women, blows upon the head, fevers, loss of sleep, syphilis, exces-
sive use of mercury, worms in the bowels, and apoplexy.
Chances of Cure. — Idiotism is never cured.
Melancholy and monomania are cured when recent, and do not de-
pend upon organic disease.
Dementia is sometimes, though seldom, cured.
Chronic insanity, of long standing, is not easily cured.
Insanity which has been produced by moral causes, acting suddenly,
is generally curable ; if the causes have acted slowly and long, the
cure is more doubtful.
Excessive study causes insanity which is hard to cure.
If caused or continued by religious ideas, or by pride, it is not
often cured.
Insanity caused and maintained by masturbation is cured with
great difficulty.
Treatment.— The treatment of the insane is now almost confined,
as it should be, to public hospitals. In these institutions, all the
means are provided which humanity has been able to devise, to lift
DISEASES OF THE BRAIN AND NERVES:
223
from these unfortunate beings the terrible shadow which is upon
them. Here they have safety, comfort, recreation, friendly guardians,
rest, and medicine.
They have safety from the annoyances which well-meaning but
mistaken friends at home almost always commit in contradicting, and
reasoning with, persuading, and threatening them ; for only in these
humane institutions has it been well learned that to do so is no wiser
than to persuade, scold, or threaten a neuralgic pain in the face, an
inflammation in the stomach, or a felon upon the finger. They are
safe, too, from the impertinent scrutiny of neighbors, the hootings of
unthinking boys in the streets, and especially from the causes, what-
ever they are, which have produced the disease. And so far, this is
just the treatment they want, — no contradiction, no impertinent
scrutiny from neighbors, no abuse in the streets, and a withdrawal of
the causes which have produced the disease.
In these institutions, too, they have comforts. They have clean
rooms, galleries, lodges, bathing-rooms, yards and gardens for exer-
cise and walking, safe, quiet, well-aired bed-rooms, and clean and
comfortable beds ; cheerful dining rooms, and plain, wholesome, and
nutritious food. And this, likewise, is the treatment they require.
They have recreation, — dances, cards, back-gammon, chequers,
chess, billiards, nine-pins, walking parties, riding parties, gardening,
and an indulgence in those arts of painting, music, drawing and
architecture for which they may have a taste. And such recreations
are powerful instruments in the cure of all disorders of the nervous
system.
Here, too, they have friendly guardians, who have long studied
their complaints, and have imbued their souls with a sympathy which
goes down into the depths of their sufferings, and allies itself with all
their sorrows ; — men and women who are willing to act the part of
guardian angels ; to be their friends ; who know how to gain their
confidence ; and who use the influence acquired by love, in leading
them back towards health and happiness. And this, too, in curing
the insane, is of great consequence, for none can do them good till
they have their confidence, and this can be gained only by love and
wisdom.
In these insane asylums, they find rest. When the brain is hot
from inflammation, and they are raving from delirium, they are here
withdrawn from the noisy crowd, and shielded from the rude shocks
of the world. If need be, they are placed in solitary rooms, where
silence spreads its soothing stillness through their excited brains.
And it is of the greatest importance that the sore and torn feelings
should rest ; for rest allays excitement, and brings sleep ; and with-
out a proper amount of sleep recovery is not possible.
Finally, in these institutions, they receive the best medical treat-
ment. They have warm and cold bathing, judiciously administered;
they have simple cathartics when the bowels are bound, as salts, cas-
224
DISEASES OF THE BRAIN AND NERVES.
tor oil, and magnesia ; tonics for debility, such as quinine, iron, cas-
sia, columbo, chamomile ; and quieting medicines for their excite-
ment, such as opium, morphine, cicuta, hyoscyamus, belladonna, stra-
monium, scullcap, and valerian. Prescription 74 is a combination
much used. Here, too, broth, gruel, and milk, are administered by
the forcing pump to such as take a fancy not to eat, — an expedient
which has saved many lives. Fruits of all kinds, as strawberries,
cherries, currants, plums, apples, peaches, and grapes, are allowed
freely. Cold water, sweetened or otherwise, is the drink. To these
things are added lively conversation, and whatever will divert the
mind from reflection, and internal imaginings and revery.
Thus I have indicated, very briefly, the treatment which the insane
receive in public institutions. That the chances of recovery in these
humane retreats is much greater than at home, does not admit of a
doubt. When it is not convenient to send an insane person to a hos-
pital, the treatment should be as near like the one here sketched as
circumstances will permit.
Hypochondria.
The common names of this disease are low spirits^ spleen^ vapors,
nypo, and the blues. It produces constant fear, anxiety, and gloom.
Business, pleasures, the acquisition of knowledge, and all the useful
pursuits of life, become insipid, tasteless, and even irksome to the hy-
pochondriac. His mind is full of the belief that something dreadful
is about to befall him. He is either going to be sick, or to die, or
lose his property or friends. He has no mind to engage in any busi-
ness, nor does he wish to go anywhere, or to see anybody. Night
and day his spirits are down to zero, and his heart has a load too
heavy to bear. He is wholly occupied with his troubles and his feel-
ings. He thinks he has various diseases, and wears out his friends
by talking of his sufferings. He feels of his pulse often, looks at his
tongue in the glass, and several times a day asks a friend if he does
not look pale or sick.
The external senses manifest symptoms of derangement as well as
the thoughts, feelings, emotions, and passions. There are roarings in
the ears, like a waterfall, or the noise of a distant carriage. Floating
black specks, or bright sparks, are seen before the eyes. These indi-
cate a slight fulness of the blood vessels, and perhaps, in some in-
stances, sparks of electricity passing to or from the eye, and are in no
proper sense subjects for the alarm they cause. At one time the per-
son will feel as large as a barrel, at other times not larger than a
whip-stock; the head will feel light or heavy, large or small. The
skin will twitch in different parts, or feel numb, or have the sensation
of spiders crawling on it. The smell and taste become perverted ;
the hypochondriac will smell odors and flavors, at times, where there
are none.
DISEASES OF THE BRAIN AND NERVES.
225
These errors of the senses are all owing to some slight disorder of
the organs of sense ; and they are no more wonderful than that the
mind should perceive personal danger, poverty, and death itself, when
none of these things are impending.
These persons are subject to fainting turns, when the breathing
will appear to stop, the body become cold, the face pale ; there will
be distress in the region of the heart, which will apparently stop beat-
ing, and the person will feel as if dying. At the same time the mind
will remain clear. These nervous spells are alarming, but pass off
without danger.
These persons become changed in their moral dispositions. They
are jealous, take a joke as an affront, and feel the greatest distress at
any apparent lack of attention or neglect on the part of friends.
They put the worst construction upon the actions of friends. They
are irritable, fretful, peevish, and fickle.
The complaint is distressing, but does not appear to shorten human
life.
The seat of the disease is in the brain and nerves. It is caused by
anxiety, care, disappointment, working the brain too hard, diseases of
the liver and stomach, costiveness, sedentary habits, excessive vene-
real indulgence, and masturbation.
Treatment. — This disease is more easily prevented than cured. It
would be almost entirely prevented in this country if in childhood we
were all taught to be contented with humble competence, to love ac-
tive labor, and to think it honorable, instead of struggling after
wealth, and falling into unhappiness when it does not come.
Remedies. — Of all the remedies for this complaint, that which is
most important is active employment out of doors. The human body
was made for motion. Without it the blood cannot be distributed to
the several organs. The senses, — the eye, the ear, the touch, —
should be much in communion with nature. In this way they are
strengthened. Nature is their great physician. Man is a creature of
sensation; and if too much occupied with feelings, thoughts, and deep
reflections, the nerves will be irritated, and begin to give deceptive
sensations. A very nervous man should fly to some active occupa-
tion, if he would be rid of suffering.
The open, fresh air is very important to restore the system to
soundness.
Temperance, both in eating and drinking, will do much for this
class of patients, yet they are the very persons who eat largely, and
they often fly to the excessive use of stimulants to drive away their
sorrow. By so doing, they aggravate the disease.
Amusements are very important for hypochondriacs. Lively com-
pany, cheerful and witty conversation, with mirth and laughter, lively
songs and instrumental music, are all desirable ; and so are gunning,
fishing, riding, billiard-playing, and travelling.
226
DISEASES OF THE BRAIN AND NERVES.
Never allow these patients to be alone, and to have time to brood
over their misery. See that they go early to bed, and rise betimes in
the morning. The warm bath, the cold shower, or sponge bath, with
brisk friction, are not on any account to be omitted. The diet should
be light, nutritious, and generous ; but fats, acids, liquors, and coffee,
must be forbidden.
But little medicine will be required. If there be costiveness, let
cracked wheat be eaten; if this does not answer, a little rhubarb
and bicarbonate of potassa (35), or leptandrin, podophyllin, etc. (36),
may be given as required by the symptoms. A teaspoonful of cal-
cined magnesia once a day, or the infusion of thoroughwort, drank
cold, will often answer an excellent purpose. A bowl of warm
motherwort tea, with a teaspoonful of spirits of camphor in it will do
well in fits of fainting when there is a sensation of dying. A tea-
spoonful of sulphuric ether maybe given at the same time. If there
be debility, tonics are sometimes useful (50), (49), (54), (55).
Hiccough. — Singultus.
This is a sudden, jerking spasm of the midriff, occurring every few
moments in bad cases, causing the air to be driven out of the lungs
with such suddenness as to produce a noise something like the invol-
untary yelp of a puppy. It is generally caused by acidity of the
stomach, which irritates the nerves distributed to its neighborhood,
and is not difficult to remove ; but when it occurs towards the close
of some acute and grave disease, it is sometimes a sign that dissolu-
tion is at hand.
Treatment. — Startle the person suffering, by exciting surprise, or
fear, or anger ; or let a few small draughts of cold water be taken in
quick succession; or, let the breath be held as long as possible. If
the stomach is sour, take a teaspoonful of bicarbonate of soda, dis-
solved in half a tumblerful of cold water. To expel wind from the
stomach, if it be present, take some warm aromatic essence of pep-
permint, ether, or compound spirits of lavender. But one of the
most effectual remedies is heavy pressure made upon the collar bones.
It is simple, and very effectual. Cocaine, one-eighth grain every fif-
teen minutes, is a very simple and often efficacious remedy.
Fainting. — Syncope.
Fainting is preceded by a distress about the heart, a swimming
of the head, sometimes sickness at the stomach, coldness of the hands
and feet, and a loss of sight, or a sense of things growing dark. The
breathing diminishes, the pulse becomes small, the face deadly pale,
and the patient wilts down, and becomes more or less unconscious of
what is passing around.
Whatever causes debility, particularly of the nervous system, will
DISEASES OF THE BRAIN AND 1<^RVES.
227
predispose to fainting. Persons much weakened by disease, faint
easily, especially when they attempt to stand still. When on their
feet, such persons should keep moving. Fainting is sometimes in-
duced by sudden surprises and emotions, by violent pains, by the
sight of human blood, and by irritation of the coats of the stomach
by indigestible food.
Treatment. — Lay the patient upon the back, with the head low ; let
fresh air into the room instantly, and apply gentle friction. Sprinkle
a little cold water upon the face, and hold spirits of camphor, ether,
hartshorn, or vinegar to the nose, — rubbing a little of the spirits of
camphor upon the forehead, and about the nostrils. As soon as the
patient can swallow, give a teaspoonful of compound spirits of lav-
ender, with ten drops of water of ammonia in it.
Persons subject to fainting should not go into crowded assemblies
where the air is bad ; neither should they wear tight dresses, or allow
themselves to get excited. Cold bathing, a well-regulated diet, and
vegetable tonics, will do much to break up the habit.
Dizziness of the Head.— Vertigo.
This affection makes objects which are stationary appear as if
moving, or as the phrase is, “ turning round.” When seized with it,
one will have a sensation as if falling, and objects about him will
seem to be in motion.
It is caused by irritation of the nerves of the stomach in dyspep-
sia, by long application of the mind, by a weakened nervous system,
by hysterics, and by a fulness of the blood-vessels of the head.
When it proceeds from most of these causes, it is not dangerous ; but
when caused by impending apoplexy, it is a symptom of very serious
import.
Treatment. — Find out the cause and remove that, and the dizzi-
ness will disappear. If it come from dyspepsia, eat lightly ; if from
costiveness, open the bowels either by coarse food, by daily cold
water injections, or by some gentle physic. Avoid coffee, ardent
spirits and late suppers, and take much exercise. Keep the feet
warm, and the head cool. See to the liver and heart.
Disturbed Sleep. — Nightmare. — Incubus.
In this complaint the sleep is disturbed generally by some fright-
ful image. Whatever of an alarming character is presented to the
mind in sleep, causes fear, or some other painful emotion, the same
as when awake. And when the attempt is made to resist, or to flee
from the danger, it is ineffectual, because the muscles are locked fast
in sleep. The fear being increased by the inability to escape, the
sleeper makes all sorts of horrible noises, indicating distress of mind.
The danger seen is as real to the sleeper as if he were awake, and he
228
DISEASES OF THE BRAIN AND NERVES.
tries to do just what he would if awake. Sometimes the sensation is
that some heavy weight, or perhaps some horrible monster, is upon
the breast, nearly pressing the breath out of the body.
At times, the power of motion is not absent, and then disturbed
dreams may cause one to talk, or to rise and walk, or run. Children
will laugh or cry, or scream, which shows that their minds are agi-
tated by different passions. Persons who indulge gloomy and troub-
lous thoughts in their waking hours are apt to be disturbed with
sleep-walking, sleep-talking, and frightful dreams, as of falling down
precipices, during the hours for repose.
There is nothing very wonderful about these disturbances of sleep.
It is only necessary that there should be an unusual sensitiveness of
the brain, or that a hearty supper, eaten late, should irritate the
nerves of the stomach, and that distressing thoughts should be dwelt
upon during the day and evening, in order to produce all the walk-
ing, talking, dreaming of hobgoblins, shipwrecks, fires and polar
bears, which distress so many unfortunate sleepers.
In night-walking there is simply a little more wakefulness than in
night-talking, and in this latter, more than when one falls from a high
place, and in this perhaps slightly more than in real incubus^ when
one is in the greatest peril, but cannot move at all.
Treatment, — When sleeping persons groan, or make any noise
indicating nightmare, shake them, and they will come out of it at
once. As these troubles are often caused by a weakened state of
the nerves, much outrdoor exercise should be taken. The diet should
be simple, and well regulated. The suppers should be light, and
never taken late. The evening should be spent in some pleasant
amusement, which will drive away care ; and the last hours of wake-
fulness be occupied with pleasant reflections. One afflicted with
nightmare should not lie upon the back, nor with the hands over the
head. Acidity of the stomach, and costiveness, if they exist, should
be removed by neutralizing mixture.
Headaches.
These are not always caused by disorders of the brain and nerves,
but they frequently are, and this seems the proper place to speak of
them.
It is unwise ever to neglect headaches. They are sources of great
suffering, and often lead to serious derangements of the health. In
childhood they have a more serious meaning than in adult life.
They often indicate the approach of scarlet fever, or measles, or of
other diseases.
Headaches are more common among the civilized than the uncivil-
ized ; more frequent among females than among males ; among those
of sensitive feeling than among the more obtuse ; among those who
think much than among those who think little ; among the sedentary
than among the active.
DISEASES OF THE BRAIN AND NERVES.
229
Causes of Headaches. — They are dependent on various causes,
as derangement of the circulating system, of the digestive organs, of
the nervous system, etc. Among those dependent on disturbance of
the circulation, are
Headaches from Eye Diseases. — Myopia, or near-sightedness ;
Hypermetropia, or far-sightedness ; Astigmatism, or the inability to
see equally well horizontal and vertical lines, as well as other irreg-
ularities of vision, are frequent sources of headache. These head-
aches are caused by overtaxing certain groups of muscles, or by fixing
the eyes too long on one objective point, as experienced in prolonged
study or reading, especially under unfavorable circumstances. These
headaches are more or less similar in their symptomatology. The
ache is generally dull, situated mostly in forehead and over eyes, but
may also be spread from base of brain to the eyes ; oftentimes it is
accompanied by nausea, especially after prolonged use of eyes under
improper conditions.
The treatment of these headaches consists in absolute rest of the
eye, in ease of overwork, and the fitting, by a competent oculist, of
such glasses as will rectify the irregularity in the eye proper.
Astigmatism is a common source of headaches, and often is so in-
sidious in its development as to escape attention. A rough test
may be made by drawing several horizontal and several vertical
lines in close proximity, and then placing at some distance (15 to 20
feet) from the eye. If either set cannot be as clearly seen without
blurring as the other, you have good cause to suspect Astigmatism,
and should consult an oculist. Do not dally with these eye-head-
aches, as you will be doing a permanent injury to your eyes.
Tea and Coffee Headaches. — In the nervous, and oftentimes in
the gouty and rheumatic person, the use of tea or coffee will cause
violent headaches. Tobacco likewise after prolonged use shows a
tendency to headaches. These luxuries of life should be discontin-
ued at once for at least one month. An extra strong cup of black
coffee, to be sure, will stop the headache for the time being, but only
adds fuel to the fire in the long run. Bromo-caffeine, as ordinarily
sold by the druggists, taken in teaspoonful doses every half hour,
will relieve the malady. We would strongly advise a,nyone that has
constant or periodical headaches, if he uses either tea or coffee, and
especially coffee, to leave them off entirely for three months. It may
he the sole cause, and if caused by tea or coffee, there is no possi-
bility of their cure by medicines while you continue their use.
Plethoric Headaches. — These are dependent on a general fulness
of blood. They are of two kinds. One is occasional, and lasts but
a few hours. The other lasts for days or weeks. It occurs most
often in the night or morning. Persons whose occupations require
stooping have it most. A little dizziness is generally felt on rising
up from a stooping posture. It is brought on by the bad air of
230
DISEASES OF THE BRAIN AND NERVES.
crowded rooms, and is attended by costive bowels, short breath, and
a white furred tongue.
The persistent headache is accompanied by a sense of fulness, and
sometimes of throbbing over the brows and temples, with a sensation
of dizziness, and of mist before the eyes. The sufferer fears exertion
and is constantly looking for a rush of blood to the head. Nature
sometimes relieves this form of headache by a diarrhoea, or by bleed-
ing from the nose.
There is another form of plethoric headache, differing slightly from
the above, in which there is too much blood, and it is made too fast,
but it does not circulate so rapidly. The muscles are not very firm,
and the heart does not propel the blood with much force. This form
of headache is connected with congestion.
Headaches of Indigestion. — These are caused either by taking
improper articles of food, or by eating too much of those which are
proper. The sensation in the head is not always a pain, but some-
times only a dull weight, attended by languor and disinclination for
exertion ; a tongue white in the centre, and pale red at the tip and
edges ; cold and numb fingers ; slight nausea ; languid and feeble
pulse ; dim and indistinct sight ; eyes aching when employed ; and
difficulty in fixing the attention.
Sick Headache. — This has received its name from the constant
nausea or sickness at the stomach wliich attends the pain in the
head.
This headache is apt to begin in the morning, on waking from a
deep sleep, or after sleeping in a close room, and when some irregu-
larity of diet has been committed on the day before, or for several
previous days. At first there is a distressingly oppressive feeling in
the head, which gradually merges into a severe, heavy pain in the
temples, frequently attended by a sense of fulness and tenderness in
one eye, and extending across the forehead. There is a clammy, un-
pleasant taste in the mouth, an offensive breath, and the tongue cov-
ered with a yellowish-wliite fur. The sufferer desires to be alone,
and in the dark. The hands and feet are cold and moist, and the
pulse feeble.
Accompanying these symptoms, there is a depressing sickness at
the stomach, which is increased by sitting up, or moving about.
After a time, vomiting comes, and relief is obtained.
Bilious Headache. — This is most common in summer and au-
tumn. It afflicts persons of dark complexion with black hair and
melancholy dispositions. There are two kinds, one is due to an ac-
cumulation of bile in the system ; the other, to a large secretion of
bile.
In the first variety the skin is dingy and sallow, the spirits de-
pressed, the bowels costive, and there is wind in the stomach, with a
dull, aching pain on the right sboulder. The pain is in the forehead,
DISEASES OF THE BEAIN AND NERVES.
231
eyebrows and eyelids, and the “ white of the eye ” is a little yellow-
ish. The tongue has a brown fur, and is cracked in the centre.
There is a bitter taste in the mouth on waking in the morning, after
restless nights, and frightful dreams.
In the second variety, which is due to an “ overflow of bile,” the
symptoms are much like those of the first kind, but the pain is not so
continuous. In addition to the symptoms named, there is a throb-
bing, rending pain in the head, the skin is hot and the face flushed,
the limbs are sore, and there is a luminous halo or ring around ob-
jects looked at, and a feeling of giddiness.
Nervous Headaches. — These are more common among females
than males. They occur most frequently among persons of high sus-
ceptibility, who are easily elevated, and as easily depressed. They
are often connected with indigestion.
The pain is usually acute and darting, and is made worse by light,
with a feeling as if the temples were being “ pressed together,” and
a “ swimminess ” in the head. There is sometimes a sense of sink-
ing, with a dread of falling, and great despondency and restlessness.
The bowels are generally costive, and the sight dim. The pain comes
on most commonly in the morning, lasts through the day, and abates
in the evening.
Hysteric Headache. — There is a nervous headache dependent on
the hysterical condition. It is generally confined to one small spot,
frequently over the eyebrow, and is sometimes compared to a wedge
or nail driven into the skull.
Headache from Exhaustion. — Still another species of nervous
headache arises from extreme exhaustion, produced by great loss of
blood, by diarrhoea, or by over-suckling. The pain is generally on
the top of the skull, and is often compared to the beating of a small
hammer on the head.
Brow Ague. — This is intermittent in its character, and is brought
on by exposure to cold and moisture in damp and marshy districts ;
and in this respect is much like ague.
Megrims. — This is most frequent among females. It is often de-
pendent on the same causes as Brow Ague, and is also produced by
long and exhausting watching over sick children, distress of mind,
and indigestion.
In both the above forms, the pain is intermittent, seldom lasting
long, but being of a sharp, piercing character like that of tic doulou-
reux. The pain of Megrims usually begins at the inner angle of the
eye, and extends towards the nose ; the parts being red and sore, and
the eye-ball tender. In Brow Ague, pain and great tenderness cover
an entire half of the head, compared by the patient, sometimes, to
“ an opening and shutting of the skull.” It begins with a creeping
sensation over the scalp.
232
DISEASES OF THE BRAIN AND NERVES.
Rheumatic Headaches. — These generally affect persons who have
been subject to rheumatism, and are often brought on by uncovering
the head when sweating. The pain is usually in the brow, the tem-
ples, or the back of the head, and is dull and aching, — rather an in-
tense soreness than a real pain ; and the painful part is excessively
tender upon pressure. The skin is moist, but not hotter than natural.
T reatment. — In considering the treatment, I will take up the same
order in which I have spoken of the different forms of headache.
Plethoric Headaches. — Not much medicine should be taken for
these, if it can be avoided. A diuretic (131) may be taken twice a
day, and an occasional dose of gentle physic at night, followed by (7)
in the morning. This will generally give great relief.
Meat should be taken but once a day, and the whole diet should
be spare, the appetite never being fully satisfied. All spirituous drinks,
including distilled and fermented, should be let alone, and coffee like-
wise.
Much exercise should be taken in the open air. The hair should
be kept short, and the head elevated during sleep. Bleeding at the
nose, when it occurs, must not be too suddenly stopped. Two drops
of the tincture of aconite root with three of the fluid extract of gel-
semium repeated once a half hour for three or four times will be
found to be of great value in the treatment of this form of headache.
The hot-water bottle applied to that part of the spine between the
bead and shoulder blades will also give great relief.
Congestive Headaches. — The exercise, diet, mode of sleeping,
etc., should be the same as in plethoric headaches. In this complaint,
there is too much blood in the head, and it inclines to stagnate. The
feet and hands are cold ; and gloves and stockings of wool, and other
bad conductors of heat from the body, must be worn.
Occasionally a little gentle physic (319) is desirable to induce the
bowels to act every day. If there is great debility, iron (71), (74),
(75), (320), will be required. The ice bag applied to the last six or
eight inches of the spine will call the blood to the extremities. The
aconite and gelsemium recipe as given above is also very useful.
Headache of Indigestion. — If the pain come immediately after a
meal, and can be traced to something eaten, an emetic (2) may be
taken, if the person be tolerably strong. If the pain come on some
hours after eating, take rhubarb and magnesia (28), (14), or fluid
magnesia. When the system is debilitated, take a warm draught
(322) in the morning after a light breakfast, or twice a day, a bitter
with an alkali (323). If the stomach be very irritable, bismuth, at
meal times (324), (326). When it occurs after a debauch, take re-
cipe (325).
Sick Headache. — When it results from food taken, a draught of
warm chamomile tea, or a little weak bran dy-and- water, will generally
DISEASES OF THE BRAIN AND NERVES.
233
give relief. If the sickness continue, soda and water, with a little
ginger may do well, or a mustard poultice upon the stomach (165)
may be required. As soon as it can be kept on the stomach, a dose
of physic (326) must he taken; and if relief does not come after the
operation of this, give a bitter and an aromatic (327). The patient
must have perfect rest. If there he great lack of tone in the system,
the mineral acids (328), (329) will be excellent.
The diet must be carefully regulated, as in plethoric and conges-
tive headaches. Cocaine, one-eighth grain every fifteen minutes till
the nausea stops, and then a dose of physic is an excellent method of
treatment. Ten grains of amenonol (ammonol) every hour will
stop the pain, and very often the same amount of phenacetine will
accomplish the same result.
Bilious Headaches. — These are generally connected, more or less,
with some affection of the liver.
During an attack, if the suffering he great, attended by nausea,
give an emetic (2). In milder cases, give recipe (321). If there be
costiveness, give recipe (.330) at night, and (7) in the morning.
A few doses of podophyllin, leptandrin, etc. (34), (36), (39), to re-
lieve the liver when the bile does not flow fast enough, will diminish
the frequency and force of the attack. The fluid extract of dande-
lion, taken for some time, often does good service.
The diet should be light, and chiefly vegetable, and exercise in the
open air must not be omitted. The daily sponge-bath, with friction,
is excellent,
Nervous Headaches. — The first thing to be done is to relieve the
pain, and this may generally be accomplished either by preparation
(331), or (332), or (333), or (88), or (93), or two or three drops of
tincture of nux vomica in a spoonful of water, taken three times a
day. 351 will be found usually to be of most service.
In simple nervous headache, diet is of the greatest importance ; in
hysterical cases, exercise ; in headaches from exhaustion, tonics (81),
(79), (63), (73), (64), (61), (60).
Of the simple remedies found on the druggists’ counter bromide
of caffein in effervescent form is very efficacious.
Rheumatic Headaches. — Take a light diet, with but little animal
food. Wear warm clothing, and avoid exposure to wet feet and damp-
ness generally, and go to a mild climate, if convenient.
When the local pain is great, apply hot fomentations, or a stimula-
ting liniment (334), or a mustard poultice, to the back of the neck.
In the beginning of the treatment, a little physic at night (335) is
useful. 10 grs. potassium iodide, gradually increased, in water, is
the best medicine.
Before closing this chapter on headaches, let me enter a respectful
protest against the indiscriminate use of the thousand and one reme-
dies advertised to cure headaches ; for in a great majority of cases it
234
DISEASES OF THE BEAIN AND NERV^ES.
is merely a symptom of some other disease ; for instance, Indigestion,
Fever, Bright’s Disease, Softening of the Brain, Diseased Liver, etc. ;
and the use of these remedies serves rather to increase than lessen
the difficulty. Much has been written and much printed matter
been given away by patent medicine venders vaunting their specific
cures for headaches. These venders have grown in numbers of late,
since the introduction into medicine of the coal-tar products, so that
samples of headache cures may be found on one’s doorsteps every
little while. For the most part they are composed of what is known
as acetanilide or antifebrin, because of its cheapness as compared with
other coal-tar products. It is, however, the most harmful of them
all, often causing blueness of the lips, fluttering of the heart, dizzi-
ness, faintness, etc. Of other similar products not so much danger
may be expected, and yet no one ought to resort to these remedies with-
out the consent and approval of the family physician. Eight grains
of phenacetine for an adult, repeated in two to four hours, no doubt
will cure more headaches of all descriptions than any other single
drug. Lactophenin and ammonol are some of the newer remedies for
headache which have the reputation of being efficient as coal-tar prod-
ucts 'without any of their ill effects. Antikamnia, a proprietary medi-
cine of the coal-tar group, enjoys a large sale, not only for headaches,
but for general neuralgic pain, and, if employed in six-grain doses
every two to four hours, according to the severity of the pain, will
stop a large proportion of these aches. The various combinations of
the bromides are always safe, and often quite efficient in curing head-
aches, especially if nerve-element is strong in their causation ; bromo-
caffein, bromo-seltzer, bromo-soda, etc., are generally put up in small
bottles in an effervescent and palatable form.
Locomotor Ataxia
Locomotor ataxia, also known as tabes, is an affection of the
spinal cord, and although much more is known about the disease
to-day than ever before, yet since 1847 it has had its present name.
The particular portion of the cord which controls the muscle sense
is diseased, and it is not until very late in the trouble that losses of
power are apparent. Men are more often afflicted than women, and
most of the cases occur between the ages of thirty and forty-five.
The venereal disease of syphilis is responsible for about three
fourths of all the cases, and mental worry or shock, blows on the spine,
falls, overwork, exposure to cold or storms, excessive use of stimu-
lants and tobacco, and sexual abuses, are the cause of the remainder.
Symptoms. — What are known as the three cardinal or chief
symptoms of locomotor ataxia are loss of the patella tendon reflex,
the reaction of the pupil of the eye, known as the Argyll Robertson
pupil, and the swaying symptom known as the Romberg sign.
The first is the absence of the usual sharp jerk to the leg, which
occurs in healthy persons when the tense tendon or cord just below
DISEASES OP THE BRAIN AND NERVES.
235
the knee-pan is sharply tapped, if the leg is at a right angle to the
thigh. The second is absence of reaction of the pupil to light. In
a healthy person the pupil dilates and contracts to both accommo-
dation (or distance) and to light, while in this disease it only responds
to the first.
The swaying symptom is noticed if a patient affected tries to stand
with heels together and his eyes closed. While he will be unaffected
if they are open, as soon as he closes them he sways violently and
many times will fall. Other symptoms are pains in the calves of
the legs and stomach, which shoot with lightning rapidity through
these organs. There occur tingling and burning sensations about
the head, neck, and extremities, shuffling gait, due to the loss of that
sense which tells what position the feet are placed in, and requiring
the eyes to be on the ground to prevent the patient from falling
down. Disturbances of vision occur, and later a general weakness
of the body from lack of sufficient exercise.
While a cure cannot be promised or expected, yet the disease may
be arrested and controlled to a greater or less degree and its extension
limited to slow progress.
Treatment. — Iodide of potash should always be tried in every
case and under a physician’s direction, as the time lost in experiment-
ing can never be regained. Beginning with ten grains three times a
day, rapidly increase to the point where the system is saturated, and
then continue at this point for some time. Mercury, either by the
mouth or rubbed into the skin, is a useful addition.
For the relief of pain, phenacetine or some other anodyne prepara-
tion will have to be given, though morphine should be avoided,
unless absolutely necessary, owing to the liability, as in any chronic
disease, of acquiring a habit.
Bromide of potash in doses of ten to thirty grains may be given
to quiet the nerves.
Proper exercises, not carried to the point of fatigue, massage of
the muscles, hot baths and electricity, all have their place and prove
useful.
NEURASTHENIA. {Nervous Prostration.)
Neurasthenia is a condition of the nervous system which by reason
of excessive fatigue has become so exhausted that the working
powers of the body do not act in their natural manner.
"What might cause a condition of Neurasthenia in a nervous person
would not effect a slow-going, phlegmatic person. On the other baud
a condition severe enough to cause excitability and ungovernable
irritability of temper in the latter might be sufficient to cause in-
sanity in the former case.
235a
DISEASES OF THE BRAIN AND NERVES.
It is in the high-strung, nervous society woman or the overburdened
business man that this trouble is prevalent.
Symptoms. A person afflicted with Neurasthenia may manifest
it in its simpler forms by excessive nervousness, irritabihty and
general crankiness. In aggravated form by melancholia, conditions
with gloomy forebodings, a desire to be apart from friends, the
afflicted has headaches, is unable to sleep, has dizzy attacks or ver-
tigo, loss of memory. Cannot concentrate attention for any length
of time, and later on muscular and other weaknesses are noticeable.
Treatment. Complete rest, sui able food, proper stimulation and
surroundings of improved hygienic and moral conditions. Massage,
baths of different varieties, travel, light reading, release from trying
cares, fresh air and change of occupation are necessary to effect a
cure.
%
¥
DISEASES of the THROAT
DISEASES OF THE THROAT.
(Also see Anatomy of Throat and Anatomy of Vocal Organs.)
The diseases which seat themselves in the throat, and in the great
cavity of the chest, have occupied a large share of my attention for
the last ten years. My practice in these complaints has been large,
— being drawn from every part of the United States, and the British
Provinces. No class of diseases from which men suffer are more nu-
merous than these, and none have so generally baffled the skill of the
profession. For this reason, I wish to present here a brief, practical,
and common-sense view of these complaints, which shall be of real
value to the thousands of families who consult these pages.
Increase of Throat Diseases. — A striking increase in the number
of throat diseases has been witnessed within the last few years. A
person suffering from any of them will find, on speaking of his com-
plaint, that a number of his neighbors are afflicted with troubles of a
similar kind. I have thought that in some of their forms these dis-
eases have fastened upon the throats of not less than half our popu-
lation. And when it is considered that they are the natural, and if
unmolested, the certain harbingers of lung disease, it is wise to make
a note of the above fact. As I shall describe them in the nasal cavi-
ties, the pharynx, the fauces, etc., they all have a natural proclivity
downwards. From these upper cavities they pass, by one short step,
into the larynx, — the cavity where the voice is formed, — and then,
by another equally short and easy stage, into the body of the wind-
pipe. It is a singular fact that their progress is always from the
upper breathing passages downward, and never from the lower pas-
sages upward. They afford a parallel to the order of progression in
the moral world, in which evil tendencies are toward a lower depth.
A Mistake Corrected. — Before describinsf the several diseases
which belong to this family, I wish to correct the mistake which so
generally classes them all under the term Bronchitis.
They all consist in a simple inflammation, acute or chronic, either
of the mucous membrane lining the several cavities to be spoken of,
or of the small glands or follicles connected with that membrane ;
and each disease takes its name from its particular location. Thus,
the inflammation of the membrane lining the upper part of the throat,
or pharynx, is called Pharyngitis. Inflammation in the top of the
DISEASES OF THE THROAT.
237
windpipe, or larynx, is Laryngitis. In the windpipe, or trachea, it is
Trachitis. In the bronchial tubes, it is Bronchitis. As the bronchial
tubes exist nowhere except in the lungs, below the division of the
windpipe, there can be no Bronchitis in the throat. Nevertheless, it
is the same disease with Laryngitis and Pharyngitis, and differs from
them only in being in a more dangerous place.
As the windpipe descends into the chest, it divides below the top
of the breast-bone into two branches, one going into the right, the
other into the left lung. These branches divide and subdivide very
minutely, and send their ramifications into every part of the pulmon-
ary tissue. Thus situated, Meckel has compared the windpipe to a
FlQ. 86.
hollow tree with the top turned downward, — the larynx and trachea
representing the trunk, and the bronchial tubes, with their innumera-
ble subdivisions, the branches and twigs. (Fig. 86.)
If the reader will now understand that the trunk and branches of
this bronchial tree are hollow throughout, and lined with a delicate
and smooth mucous membrane, and that the diseases to be described
are inflammation either upon this membrane or the small glands con-
nected with it, causing swelling, redness, unhealthy discharges, rough
ness, etc., he will have a good general idea of them.
Nasal Catarrh.
I TAKE these diseases in the order of their location. Nasal Catarrh
consists in inflammation, which begins behind and a little above the
238
DISEASES OF THE THROAT.
veil of the palate, and extends upward from thence into the nose. It
is an exceedingly troublesome complaint, and afflicts great numbers.
It passes under the name of Catarrh in the Head.
The inflammation is not confined to the nasal cavities. It extends
frequently to the air-cavities, called antrums and simise.% which cover
a considerable portion of the face, and extend to the lower part of the
forehead. Persons sometimes feel as if their whole face were in-
volved in the disease, and were almost in a state of rottenness, — so
great is the amount of matter discharged from the head. Such free
discharges cannot be wondered at when we reflect that all the air
cavities in the face are lined with the same mucous membrane which
lines the nose, and that they all communicate with the nasal cavities.
The “ horn ail,” among cattle, is a similar inflammation of the inner
surface of the horns ; and the “ horse distemper ” is an inflammation of
the air cavities in the head of the horse, and is much the same disease
with our catarrh in the head.
The catarrh often creates a perpetual desire to sivallow^ and gives
the feeling, as patients express it, “ as if something were sticking in the
upper part of the throat.'"’
When the inflammation has existed a long time, and ulceration
has taken place, puriform matter is secreted, and drops down into the
throat, much to the discomfort of the patient. Indeed, this is one of
the most distressing features of the complaint, as this matter often
descends into the stomach in large quantities, causing frequent vom-
iting, and a general derangement of the health. Many times the suf-
ferer can only breathe with the mouth open. Upon rising in the
morning a great effort is required to clear the head and the extreme
upper part of the throat. There is occasionally a feeling of pressure
and tightness across the upper part of the nose ; and the base of the
brain sometimes suffers in such a way as to induce headache, vertigo,
and confusion. The smell is frequently destroyed, and sometimes
the taste. The inflammation sometimes gets into the Eustachian
tubes, the mouths of which are behind and a little above the veil of
the palate, and extends up the lining membrane to the drum of the
ear, causing pain or deafness, and occasionally both. In addition to
this catalogue of evils, there is often added inflammation and elon-
gation of the uvula or soft palate.
Treatment. — The following is a fair illustration of my mode of
treatment : —
Mr. , of Boston, came under treatment for a bad case of ca-
tarrh in the head, complicated with follicular disease of the pharynx,
or upper part of the throat. In addition to nearly all the symptoms
mentioned above, he had a stench from the nose exceedingly offen-
sive to all about him. So much had the disease worn upon him that
he had become bilious, sallow, dejected, and low in strength and flesh.
When it is said that to all these were added a cough and loss of ap-
petite, with insidious approaches of hectic, it will not be surprising
DISEASES OF THE THROAT,
239
that his friends saw the most serious results impending, even though
assured by me that the disease had not yet taken a firm hold of his
lungs. The first thing done for him was to cut off the uvula. Five
days after, I began to bathe the whole nasal cavity, three times a
week, with a shower syringe, by pushing the smooth bulb up behind
the veil of the palate, and throwing instantaneously a most delicate
shower of medicated fluid up both sides of the septum.' The upper
part of the throat was likewise bathed by the use of a shower syringe
made expressly for that part, and the larynx, or place where the voice
is formed, by a long, bent instrument made to reach this part of the
throat. The solution used consisted of half a dram of crystals of ni-
trate of silver dissolved in one ounce of soft water.
The nitrate of silver powder was inhaled once a day with the pow-
der inhaler. In this way the nasal cavities and throat were kept
cleansed, and the articles used gradually subdued the inflammation,
setting up a new and healthful action in place of the diseased one.
The stomach was relieved of the offensive matter which had daily
and nightly gone down into it, and the system of the poisonous ef-
fects of its absorption. The great danger which threatened the lungs,
and which would soon have been realized in their destruction, passed
away. The skin gradually resumed its proper color; the appetite,
flesh, spirits, and strength came back, and Mr, B. has been since in
the enjoyment of good health, pursuing his business cheerfully.
When the above treatment fails, as it does occasionally, I am in
the habit of changing the solution, using sometimes a weak solution
of acid nitrate of mercury, twenty drops to an ounce of water. In
other cases, a solution of sulphate of zinc serves a good purpose. A
dilution of the tincture of arnica-flowers is a preparation of some
value in these cases. There are other preparations, too numerous to
mention, which I am in the habit of using. I will add, that the
nitrate of silver powder, snuffed once a day, a pinch at a time, is far
more successful than any other muff ever made, but should be used
only in severe cases, and with caution.
Nasal catarrh is such a common affliction in the Eastern States, as
to be a widespread curse. Douching the nose with salt and water
(warmed) cleanses the nose of the foul mucus. The douche should
be from a bag hanging only a little higher than the head, or it may be
given by means of a common, blunt-pointed syringe, care being taken
not to use too strong force, nor to point the syringe in the direction
of the eyes. The stream of water should be directed straight ahead
parallel with the floor ; the mouth must be open, and the patient as-
sume the position of the countryman when gazing or gauking at the
sights on his first visit to the city. The water then runs down the
throat and also out of the other nostril. This process should be em-
ployed on both sides till the head is clean. The tablets put up by all
wholesale druggists, called “Carl Seiler’s alkaline tablets,” is the best
remedy for a nasal douche.* The subsequent treatment is best ad-
* One of these tablets dissolved in a half cup of water. Practically the same solution may be
^ade by adding to the same amoimt of hot water 10 grains of borax, 15 grains of cooking soda
and 5 grains benzoate of soda.
240
DISEASES OF THE THROAT.
vised by a physician, and usually consists in the use of some inhala-
tion or spray.
Inflammation of the Pharynx. — Pharyngitis.
This is an inflammation of the upper and back part of the throat,
or all that part which can be seen when the mouth is stretched open.
It causes a redness of the mucous membrane lining the part, which
is deep in proportion to the intensity of the inflammation. This
complaint is generally connected with the one I am about to describe ;
and since the treatment is the same the reader is referred to what
next follows.
Adenoid Growths.
In young children a very disagreeable catarrhal affection often ex-
ists in the naso-pharynx just behind and above the uvula. This is
caused by continued catarrh till at last small growths occur like
proud-flesh, and not infrequently block up the passage from the nose
to the mouth, to that extent that not only is loud snoring produced at
night, but breathing becomes difficult by day. In severe cases the up-
per jaw becomes angular, and the face assumes a peaked, pinched look.
These growths are extremely eommon in children, and are produc-
tive of much mischief. The inability, in severe cases, to properly
breathe deprives the lungs of their proper amount of oxygen, so that
the little one suffers in nutrition and growth.
Treatment consists in scraping away with a scoop, or even with
the finger, these soft, granulating masses. The effect is almost mar-
vellous : the child breathes quietly, without snoring, the color re-
turns to the cheeks, and the blood receives a new supply of food from
the full supply of oxygen. In modern times, nothing has been in-
augurated in the treatment of children’s throat and nose diseases so
beneficial and happy.
Clergymen’s Sore Throat. — Follicular Pharyngitis.
This disorder made its appearance in this country in 1830, and the
attention of the profession was first drawn to it, as a distinct disease,
in 1832. Some have supposed its origin to have had a hidden con
nection with the epidemic influenza which spread over the civilized
world in 1830, and affected all classes of persons ; but this is only
conjecture. In its early developments it attracted notice chiefly by
its visitations upon the throats of the clergy. Hence its popular
name of Clergymen' s Sore Throat. It was soon found, however, to at-
tack all classes of persons indiscriminately, whether engaged in any
calling which required a public exercise of the voice or otherwise. It
was noticed more by public speakers and singers, on account of the
greater inconvenience it gave them.
The disease consists in a chronic inflammation of the mucous fol-
r
DISEASES OF THE THROAT.
241
licles, or glands, connected with the mucous membrane which lines
the throat and windpipe. The office of these little glands is to secrete
a fluid to lubricate the air passages. When inflamed, they spread an
acrid, irritating fluid over surrounding parts, which excites inflamma-
tion in them. Hence a general inflammation of the upper part of the
throat or pharyngitis usually attends the follicular disease, and I
shall speak of the two together. This inflammation of the glands
and the membrane, being neglected, as it generally is, lingers on from
month to month, or from year to year, making in some cases slow
progress, in others more rapid, — made a little worse and its step
slightly quickened by every fresh cold, and finally results in ulcera-
tion. The expectoration thenceforward becomes puriform, and finally
undistinguishable from that of consumption, with all the symptoms
of which the patient finally dies. Indeed, before its nature was un-
derstood by the profession, it was considered the most fatal form of
consumption, because it could be affected only in a very small de-
gree, if at all, by medicines taken into the general system. For the
milder cases one will find great comfort in the use of the troches of
cubebs and ammonia, the inhalation of benzoin with steaming water,
also from such throat-tablets as the Chloramine.
Inflammation of Mucous Membrane and Glands
of Larynx. — Follicular Laryngitis.
A FEW strong and beautifully formed cartilages unite to form a
curious and convenient box or cavity at the top of the windpipe,
called the larynx. Across this enclosure are stretched two remark-
able ligaments, called the vocal cords. They are from half to three
quarters of an inch in length, and are rendered more or less tense by
the small muscles with which they are connected. Just above these
cords are two cavities, which, with the ligaments, act an important
part in the formation of the voice. Here is produced the sound,
which is modified and articulated by the tongue, the lips, and the
nasal cavities.
When disease reaches this cavity, and the fluid secreted to lubri-
cate these cords becomes acrid, the voice, from this and other causes,
is made hoarse ; and when, at length, these ligaments are altered in
structure by inflammation and ulceration, the voice suffers a gradual
extinction. I have treated a large number suffering entire loss of
voice, and am happy to say it has been generally restored, where the
lungs have not been involved in the disease. There is often also a
little sensitiveness, or even soreness, in some cases, in the region of
the larynx, which may be felt by pressing upon that prominence in
front of the throat, called Adam’s apple. .
242
DISEASES OF THE THEOAT.
Inflammation in the Windpipe. — Tracheitis.
This complaint and the one preceding it differ only in their local-
ity from those described in the upper cavities ; and they are more
alarming, because two removes nearer the citadel of hfe. Happily,
we know that the seat of these diseases may be easily reached, and
we have a shower syringe, so arranged as to pour the remedial agent
directly upon them, without any lacerating disturbance of the parts.
Symptoms. — The approach of these disorders is often so insidious
as hardly to attract notice, — sometimes for months or even years, —
giving no other evidence of their presence than the annoyance of
something in the throat to be swallowed or hawked up, an increased
secretion of mucus, and a sense of wearisomeness and loss of power
in the throat after public speaking, singing, or reading aloud. At
length, upon the taking of a severe cold, the prevalence of an epi-
demic influenza, or of an unexplained tendency of disease to the air-
passages and lungs, the throat of the patient suddenly becomes sore,
its secretions are increased and rendered more viscid, the voice grows
hoarse, the difficulty of speaking is aggravated, and what was only
an annoyance becomes an affliction and a source of alarm and dan-
ger. These diseases clearly belong to the family of consumption, and
need early attention.
Causes. — It is amusing to reflect upon the theories which writers
were in the habit of constructing, a few years since, to account for
the throat affection among the clergy. It was attributed by some
to speaking too often, by others to speaking too loud. One class of
writers thought it arose from muffling the neck ; another, from a
strain of voice on the Sabbath to which it was not accustomed on
other days.
The cause lies deeper than any of these trifling things. As it con-
cerns ministers, it may generally be expressed in two words, — labor,
anxiety.
The clerical order are placed just where they feel the force of the
high-pressure movements of the age. They are the only class of
recognized instructors of adult men, and are obliged to make great
exertions to meet the wants of their position. The extremely tiyiag
circumstances in which they are often placed, too, in these exciting
times, by questions which arise and threaten to rupture and destroy
their parishes, weigh heavily upon their spirits, and greatly depress
the vital powers. And, when we add to this the fickle state of the
public mind, and often the shifting, fugitive character of a clergy
man’s dwelling-place and the consequent liability to poverty and want
to which himself and family are exposed, we have a list of depressing
causes powerfully predisposing to any form of disease which may
prevail.
DISEASES OF THE THEOAT.
243
It will be pardoned me, I think, if I suggest here, that the nature
of a clergyman’s calling is of so serious a character, that he some-
times carries himself with too much sedateness, keeps himself too
much braced up, and does not allow himself hours enough of that
cheerful, light-hearted abandon, which is essential to the health of
every sedentary man of mental habits. The hard-thinking and hard-
working minister, who will retain his health and save his throat, must
have some moments, at least, when the weighty responsibilities of his
office are lifted up from his soul, and he becomes, for the hour, the
jocund, playful boy of earlier days. How far he can consistently re-
lax and let himself down, or in my view of the matter, raise himself
up to the simplicity and mirth of childhood, he alone can be the judge.
As a physician, I prescribe ; as a minister, he must decide how far
my prescription can be followed.
Reading Sermons. — There is one practice, which, though it has
not much to do with inducing this disease, does frequently aggravate
it when once established ; I mean the habit of reading sermons from
manuscripts, — especially when it is done in a sort of mechanical
way. Every person who has suffered from throat-ail has doubtless
noticed that to read aloud, for half an hour, from a book, occasions
more fatigue and irritation in the throat than extemporaneous speak-
ing, in the same tones, for one or two hours. The reason is, that in
the latter case the mind conceives the thought in season for the or-
gans of speech to fall into a natural attitude, and utter it with ease.
The two work harmoniously together, — the instruments of articula-
tion following the mind, and easily and naturally uttering its concep-
tions. Whereas in the case of reading, the mind itself is, at least
partially, ignorant of what is coming until it is just upon it, so that
the organs of speech, being warned of what is to be done only at the
moment their service is required, do their work under a perpetual
surprise and constraint. The difference is, in some respects, like that
between walking freely at large, without regard to where the feet are
put down, and being obliged to step exactly in the footprints of some
traveller who has gone before. In the latter case, the muscles tire
much sooner, because they work in fetters.
I have thus spoken particularly of the clergy, though it is not by
any means they only, but all classes of people who are afflicted with
this dangerous malady.
These diseases often legin with a cold. But colds are seldom taken
except when the nervous system is depressed, so that they are, in fact,
to he traced back to the same cause which I have assigned to catar-
rhal or throat complaints themselves.
These Complaints Worse at Night. — It is worthy of note, that all
these complaints, and many others, are worse during the night. This
is easily explained when we remember that the atmosphere has the
least amount of electricity in it at three o’clock in the morning, and
that the first minimum atmospheric pressure, which happens twice a
244
DISEASES OF THE THROAT.
day, occurs not far from the same hour. From three to four in the
morning, therefore, the nerve-power sinks to its lowest ebb ; and those
diseases which owe their existence to anxiety, overwork, etc., suffer,
at this time, their greatest daily aggravation. Death occurs, too, more
often during these hours, than in any other portion of the twenty-
four.
Treatment. — Some years ago these diseases were thought to be
incurable ; and by all the appliances of medical art then known, they
were so. But time has brought a successful method of treatment, as
well as a clearer knowledge of their nature.
This treatment consists in what is called topical medication, or the
applying of the medicine directly to the diseased part. The medici-
nal agent more extensively used than any other is a solution of crys-
tals of nitrate of silver. This substance is not, however, adapted to
every case, — other articles succeeding better in some instances. Mod-
ern chemistry has given us a variety of agents from which the skilful
physician may select a substitute, should the nitrate of silver fail.
The operation of applying this and other substances to the air pas-
sages, is a delicate one, requiring tact and experience. Surgeons had
supposed it an anatomical impossibility to introduce an instrument
into the larynx ; but this has been practically demonstrated to be a
great mistake.
Instruments. — The instrument devised and used by Dr. Horace
Green is a piece of whalebone, bent at one end, to which is attached
a small, round piece of sponge. This, dipped in the solution, is dex-
terously introduced into the laryngeal cavity, and applied directly to
the diseased part.
I formerly used this instrument myself, and am happy to know,
that, notwithstanding its defects, it was generally successful. Yet
where the larynx was highly inflamed, with a swollen and ulcerated
condition of the epiglottis and lips of the glottis, I am sure I some-
times had the singular powers of the nitrate of silver put at defiance
by an irritation evidently produced by the sponge of the probang.
Upon its introduction, in such cases, the parts contract upon and
cling to it, and suffer aggravated irritation, almost laceration, upon
its withdrawal, however carefully effected.
Laryngeal Shower Syringe. — Such defects in the probang led me
to contrive an instrument, which I call a Laryngeal Shower Syringe.
It is in the form of a syringe, the barrel and piston of which are
made of glass, silver, or gold, as may be desired. To this is attached
a small tube, made of silver or gold, long enough to reach and enter
the throat, and bent like a probang, with a globe or bulb at the end,
from a quarter to a third of an inch in diameter, pierced with very
minute holes, which cover a zone around the centre about one-third
of an inch in breadth.
This silver bulb I daily introduce into highly inflamed and ulcer-
i
DISEASES OF THE THROAT. 245
ated larynges, generally without any knowledge of its presence on
the part of the patient, until the contained solution is discharged.
The instrument, being charged, is carried to the proper place, when a
delicately quick pressure upon the piston causes very fine streams to
fiow through the holes in the form of a delicate shower, and all sides
of the walls of the larynx are instantaneously bathed.
How Introduced. — The introduction of this instrument into the
larynx is easy. Upon the approach of any foreign substance, the epi-
glottis instinctively drops down upon the entrance to the larynx,
guarding it against improper intrusions. It has been found, however,
that when the root of the tongue is firmly depressed, this cartilage
cannot obey its instinct, but stands erect, its upper edge generally ris-
ing into view. Availing himself of this, the surgeon has only to de-
press the tongue with a spatula, bent at right angles, so that the left
hand holding it may drop below the chin out of the way, and as the
epiglottis rises to view, slip the ball of the instrument over its upper
edge, and then with a quick yet gentle motion, carry it downward and
forward, and the entrance is made. I have often admired the faith-
fulness of this epiglottic sentinel, who, when overborne by superior
force, stands bolt upright, and compels us to enter the sacred temple of
speech directly over his head !
Pharyngeal Shower Syringe. — For washing the upper part of the
throat, I construct the instrument with a straight tube, with holes
over the outer end of the globe, and extending to the centre. This
washes instantaneously the fauces and pharynx, but does not throw
the solution back upon the tongue. Its main advantage over the
probang is, that it bathes every part of the fauces and pharynx in-
stantaneously, and does not subject the patient to tire coughing and
gagging which follow the slower and rougher process of drawing the
sponge from side to side across the cavity of the throat.
Nasal Shower Syringe. — Inflammations in the back passages to
the nose, called catarrh in the head, have been almost inaccessible by
any reliable healing agent, and consequently incurable. The probang
could only reach a short distance, and occasioned great suffering. I
have had a syringe constructed with the tube bent at an angle of
forty-five degrees, and the globe, very small, pierced with a few fine
holes at the upper end. Carrying this globe up behind the velum
palati, with a single injection I wash both passages clear throu gh. I
have had the pleasure of curing a large number of bad cases, of many
years’ standing, to the surprise and delight of the patients.
About nineteen-twentieths of the physicians who have examined
these instruments, and so far as my knowledge extends, all who have
used them, think them much better than the probang. As to patients,
I have yet to see one who will allow the sponge to be used after try-
ing both.
Have Superseded the Probang. — In my own practice the syringes
246
DISEASES OE THE THROAT.
have superseded the probang altogether. My reasons may be briefly
stated. I have already said there is less irritation produced. A piece
of sponge drawn over an inflamed surface, especially when elung to
by the irritated and quivering parts, must neeessarily, in some cases
at least, aggravate the symptoms of disease. To this eonsideration
add the comfort of the patient during the operation. It is so quickly
and delicately done with the syringe, that it is scarcely known when
the act is performed. The straight syringe does not touch the throat
at all. On toucliing the probang to the throat, the nitrate of silver
unites with the mucus upon the surface, instantly covering the sponge
with an albuminous pellicle, something like that which lines the shell
of an egg, preventing, in a degree, the further pressing out of the
solution, and rendering its contacts with other parts of the surface
comparatively powerless. For this reason, the sponge pushed down
into an uleerated bronchus, as Dr. Green recommended, must be ut-
terly valueless as a remedial agent. Mopping, as it does in its whole
course, a larynx and trachea, lined in some cases with puriform mat-
ter, and generally with mucus, every inch of its descent doubles the
gravity of this objection. Let it be considered, too, that in applying
the remedy to an ulcerated larynx, the sponge cauterizes the healthy
parts above, in its descent, and thus unfits itself for doing much for
the diseased part ; whereas the syringe retains its solution till it
reaches the affected place, and then pours a clean shower directly
u^ion it, and upon no other part.
Considering these manifest advantages of the syringes, I am sur-
prised that any physician should still use the probang, — especially as
one of these instruments, the Nasal Syringe, accomplishes an object
which the probang cannot effect at all, not even in a rough way. I
have wondered, too, how any parent can allow a clnld, suffering with
croup, to be tormented by having a sponge pushed down its throat,
when a syringe would give it so much less pain.
I will mention briefly one or two cases of croup and diphtheria, se-
lected from a great number treated by me for the last few years, where
the syringes were successfully used, after several attempts to use the
probang had been made, and failed, and where the pain caused by
using was so small, and the relief so instantaneous and complete, that
the patients were anxious for my return to use it again.
I was called to see a little boy of Mr. R., five years old, who had
had an attack of membranous croup some days previous ; and when
I saw him the voice had sunk to a whisper, and the cough was en-
tirely muffled, so that I had no doubt of the fatal termination of the
case, and expressed my opinion to that effect to the astonished parents.
The probang had been used by the physician in attendance, which
had caused so much suffering that for the two days previous the par-
ents had prohibited its use. It had no doubt increased the irritation,
besides nearly causing strangulation.
It was, therefore, with great reluctance that they consented to let
DISEASES OF THE THROAT.
247
me use the syringe, which I did, to the great relief of the little suf-
ferer, and to the entire satisfaction of the parents.
The strength of the solution of the crystals of the nitrate of silver
used was 20 grains to the ounce of water, which I injected freely,
once in three hours for the first day, and then two or three times a
day for two or three days. His recovery was rapid and complete.
I will now mention the case of a young woman, with diphtheria,
where the S3rringe was used with success.
I was called to see a young lady, who had an attack of diphtheria
the day previous. Found her in bed, very much prostrated, breath
ing with great difficulty, and uttering at every inspiration a croupal
sound, which at times was followed by a short, convulsive cough.
The face was flushed, pulse 124, small and feeble, and she complained
constantly of a sense of suffocation and of great distress in the lar-
yngeal region.
On inspecting the throat, the fauces and the pharyngeal mem-
brane, as far down as it could be seen, presented the appearance of a
high degree of inflammation. One of the tonsils was nearly covered
with the diphtheric membrane, and the upper and back part of the
throat were thickly studded with small wliite or cream-colored spots.
The physician in attendance had tried first a swab, or mop, as she
termed it, and then the probang, which gave her so much pain that
he was obliged to give it up. He then gave up the case as hopeless.
At my earnest solicitation she consented to the use of the syringe.
With a solution of the crystals of the nitrate of silver, of the strength
of 60 grains to the ounce of water, I injected freely the fauces and
the upper part of the cavity of the larynx. For a few moments the
difficulty of breathing and feeling of strangulation was increased,
but very soon a large amount of viscid, ropy mucus was discharged.
In the course of half an hour after the use of the syringe, the symp-
toms had improved, the respira-
tion was less laborious, so that
in a short time the patient ob-
tained some sleep. I was after-
ward called, as she thought her-
self worse, but found that an
application of the caustic with a syringe was all that was required.
There was no further trouble with the case.
These syringes or similar ones can now be bought of any large
dealer in surgical instruments. Figure 87 represents the syringes as
they lie in a case.
Mode of Using. — The glass barrel and piston of my instruments
are delicate, but they need not be broken. I handle them with the
same ease that I do a spoon in feeding myself, and not in a very dis-
similar way. The last three fingers are placed on the under side of
the barrel, with the thumb on the upper side, — the index finger be-
ing poised over the end of the piston, ready to drive it home at the
248
DISEASES OF THE THROAT.
proper instant. The motion of the piston should be quicks so as to
cause the streams to leap out in jets ; yet delicate^ that they may not
impinge with too much force upon the diseased surfaces.
They should be rinsed with water immediately after being used.
But even with this precaution, a small residuum of the nitrate re-
mains and crystallizes, and after a time partially closes the holes.
They must then be picked out with the point of a needle.
When the silver tube becomes detached from the glass, it may be
fastened on with common sealing wax ; first melting the wax and
sticking it around the glass; then heating the silver over a lamp, and
pressing it on.
Amount of Solution to be Used. — The amount of solution to be
used should be small. Half a dram is enough. The piston of the
syringe need be drawn up only from an eighth to a third of an
inch. Strangling is not often produced by these operations ; but to
make its prevention still more sure, let the patient be directed to fill
the lungs with a long inspiration while the operator is depressing the
tongue.
Strength of Solution. — The strength of the solution in ordinary
cases of chronic folliculitis, etc., should generally be about forty
grains of the crystals of the nitrate of silver to the ounce of water.
But in all acute diseases of the air passages, it should be considerably
stronger, — varying from one to two drams. A preparation of this
strength is powerfully antiphlogistic and sedative. In those cases of
chronic disease, where the inflammation is of a low grade, and the
mucous membrane is in a relaxed, atonic condition, looking either
sodden and pale, or of a dark color, like the cut surface of beef some
days exposed to the air (as is often the case in throats of literary dys-
peptics), then a solution of fifteen to thirty grains to the ounce is
sufficient. This strength acts as a stimulant, and is well suited to
throats in such condition, but would be injurious in high grades of
inflammation. Catarrh in the head generally requires only about this
strength. I am sorry to say, the topical mode of treating throat affec-
tions has been in some places injured, in the public estimation, by a
lack of knowledge and judgment on the part of the operator, in
choosing the strength of his solution.
To determine the proper frequency of the operation^ also requires
judgment and experience. In an ordinary case of chronic disease,
the treatment may begin by showering the throat once a day for a
week. Then the operation should be repeated three times a week, for
a shorter or longer period ; then twice a week, and at last once a week.
Attendant Diseases. — Among the persons I am treating for dis-
eases of the air passages, many are dyspeptic and suffer with depres-
sion of spirits. So often does this symptom present itself that I re-
gard it as almost one of the peculiarities of throat disease. Persons
thus depressed generally have the dark and dingy look of the face
which indicates functional derangement of the liver. They are often
DISEASES OF THE THROAT.
249
emaciated, nervous, hypochondriacal, irritable in temper, and are ex-
hausted by an excessive secretion of urea. The urine of such per-
sons is always acid, and loaded with crystals of oxalate of lime.
An explanation of this fact has been attempted, by supposing that
the oxydation of carbon (of which these persons have a superabun-
dance), imperfectly accomplished in inflamed respiratory organs, is
vicariously effected in the capillaries of the kidneys, — oxalic acid
(C2O2) instead of carbonic acid (COj) being the result.
The crystals of oxalate of lime are octahedral in form, and, in the
field of a good microscope, are beautiful objects for inspection.
Lawyers, clerygmen, statesmen, and, in general, those who labor
hard mentally, with but little bodily exercise, and who have a great
weight of care resting on them, are the persons who suffer most from
this complication. Generally the inflammation in the throat is of a
low grade, and must not be treated with a very strong solution of ni-
trate of silver.
Of course when these attendant diseases exist, something more is
needed than the local treatment. For the troubles just described, the
treatment for hypochondria and dyspepsia will be proper.
Elongation of the Uvula.
The uvula is the small teat-like or
pendulous organ which hangs down
from the palatine arch, just over the
root of the tongue. It is very apt to
get inflamed, and its parts becoming re-
laxed, it stretches out lengthwise, so
that its lower extremity sometimes rests
upon the tongue. (Fig. 88.) When
this happens, it flaps about, backward
and forward, and to the right and left,
— touching the throat at various points,
and by the tickling sensation produced,
exciting a most incessant, uncontroll-
able, and racking cough. Some of the
most distressing coughs I have ever
heard have been produced and kept up
by this cause alone. Many a fatal con-
sumption has begun in this way. When
long inflamed, it often gets much out
of shape, being sometimes bent nearly
double.
Treatment. — In some cases, the
uvula, thus elongated, may be reduced
back to its natural size, by an astrin-
gent gargle, composed of an infusion of
white-oak bark, with a little alum dis-
FiQ. 88.
250
DISEASES OF THE THROAT.
solved in it (232) ; but it will generally stretch out again and again,
upon the appearance of any fresh cold, and, therefore, the only certain
cure is to cut it off.
To do this, take hold of it with a pair of common forceps, and
having stretched it down a little, clip it off above the forceps, with a
pair of curved scissors. Nearly the whole of it should generally be
removed. To take off a part only leaves a stump, which is often
more objectionable than the whole organ. Its removal never injures
the speech in the least. In 'many cases of nasal catarrh, this organ
is a sort of diseased centre, from which inflammatory action spreads
upward into the nasal cavities, and no medicine or power on earth
can effect a cure until this offending member is snipped off.
Acute Inflammation of the Tonsils. — Tonsilitis.
The tonsils are chiefly a collection or mass of small mucous folli-
cles or glands. They secrete a portion of the fluid which keeps the
throat moist.
There is a class of persons who suffer about every winter, some-
times oftener, with an attack of acute inflammation of these glands,
which causes great suffering for several days. The trouble usually
is ushered in by high fever, backache, headache and often by chills;
the temperature often reaches to 103° and 104° F. ; swallowing is
difficult on account of the swollen glands, while pain in the ear is
not infrequent. The tonsils are at first swollen, reddened and in-
flamed; later a whitish j)atch of secretion forms on the surface of
the gland and is distinguished from that of diphtheria by being
whiter and less tenacious ; if removed, the underlying surface does
not bleed as in the case of diphtheria. It is, however, very difficult,
at times, to distinguish between the two diseases at first.
Another form of Tonsilitis occurs without patches, and is in
reality an inflammation of the substance of the gland itself. This
variety, often called Quinsy, goes on developing into an abscess, the
anterior pillar of the fauces becomes intensely red, swollen and
shiny.
Treatment. — For the more common variety some antipyretic to
reduce the fever and allay the intense aching of the head and bones
is properly indicated. For this purpose 10 grains of Phenacetine
(for an adult), repeated every two to four hours according to the
effect produced, is quite efficacious. Ammonol in same dose may
also be used. Some simple astringent and soothing gargle will next
be found to render signal relief. Tannin, 30 gr., strong Carbolic
Acid (95%), 30 drops, Glycerin, 1 oz., and peppermint water, 3 oz., is
an admirable garglefor the average case: this should be used hourly.
Equal parts of Glycerin, Alcohol and W ater makes a very sooth-
ing gargle, while equal parts of Peroxide of Hydrogen and Water is
preferred by many. The diet should be limited in amount and con-
sist only of liquids.
DISEASES OF THE THROAT.
251
Tincture of aconite in 1 or 2 drop doses together with half teaspoon-
ful of sweet spirits of nitre repeated every hour will help to allay the
fever and congestion of the throat, and goes far to prevent pus forma-
tion which is usually spoken of as Quinsy sore throat. This abscess,
if formed, may be evacuated by the physician, who alone should at-
tempt it, as the region is a dangerous one, being close to the carotid
artery and jugular vein, which would cause instant death if cut.
It has been found that Tonsilitis is apt to be recurrent and that
he who has suffered once is very prone to have one or more attacks
annually thereafter. This class requires constitutional treatment in
the intervals as outlined below.
These inflammations are likewise found to be an expression often-
times of rheumatism, and need corresponding treatment. But the
only cure is to be found by cutting off the tonsils, after the inflam-
mation has subsided. This will put an end to the attacks at once.
Tonsils which are subject to these periodical attacks of acute in-
flammation are always more difficult than others to operate upon, as
they are almost invariably bound down very tight to the throat, and
cannot be raised up for convenient excision.
Chronic Inflammation of the Tonsils.
In many of the follicular diseases of the throat, these glands are
affected by a chronic inflammation, and are found enlarged, and
sometimes very much hardened. In such cases they secrete a thin,
unhealthy, irritating fluid, which is spread over the throat, increasing
and perpetuating its disease. Much of this secretion finds its way
into the stomach, and thence into the circulation.
In the throats of many young persons and children, these glands
ure permanently so large as nearly to fill the fauces. The respiration
of many children thus afflicted is difficult, and when asleep they can
only breathe with the mouth open. The defective breathing of such
children often occasions contractions of the chest, and thus lays the
foundation for consumption. From these diseased parts, the inflam-
mation often spreads upwards, into the posterior nares, and many
times enters the eustachain tubes, causing deafness or pain in the ears.
Such children often breathe as though they had a bad cold in the
head. Their health and safety require an immediate attention to
this state of things.
Chronic inflammation of the tonsil, likewise the recurrent acute
form, maybe dependent on poor blood or rheumatism. Those causes
are met by blood-building medicines like Syrup of the Iodide of Iron
in 10-drop doses three times daily, cod liver oil, and by some one of
the many preparations of iron, arsenic, and strychnia combinations.
It is found that generally the excision of the tonsil may be averted
by visiting the surgeon, who will hunt out the little crypts or holes
with which the gland is studded, and by gently cutting the narrow
252
DISEASES OF THE THROAT.
bridges which separate these holes, destroy these cavities. These
little holes retain small particles of food and decomposed secretion,
which after a while, if allowed to remain, set np a follicular tonsil-
itis. The size of the gland is thus greatly diminished and the little
secreting follicle destroyed. Many a little sufferer can thus be spared
the harsher method of excision, and bear with good grace, especially
if cocaine be used, what otherwise might be a painful and bloody
operation. But, as has been said, excision in many cases must be
resorted to.
Curability of Throat Diseases. — I have dwelt somewhat upon
the preceding forms of throat disease, because they prevail to a fear-
ful extent, and are, in thousands of cases, but the first stages of fatal
disease of the lungs.
If not connected with lung disease in the beginning, my experience
in treating them enables me to say, emphatically, they are generally
curable.
But patients often put the question to me — “ If cured, will I ever
have the complaint again?” My answer is — “ Unless I can plant
in your constitution a better protection than your Maker put there at
your creation, you will of course be liable to a second attack.” But
then, where the lungs have been entirely free from disease, I have
never yet seen a case of simple throat complaint relapse and become
dangerous after proper treatment with the syringes. Let not those,
therefore, who have been benefited, but not entirely cured by this
treatment, undervalue what has been done for them. Even in such
cases, the advantage derived to them amounts to just the value they
attach to the continuance of life.
Dangers of Delay. — In closing these remarks, let me warn the
reader against the dangers of delay. Many of those who finally seek
medical attendance in these complaints, first try all nostrums, and
tamper with their disease till the case is either critical or hopeless.
Too many wait till they are near enough to the engulfing whirlpool
to hear it roar, before they seek in any practicable way to escape its
dangers.
Many persons neglect a slight inflammation of the pharynx, which
might have been cured in a few days, but which, from long neglect,
has. gradually crept down the windpipe, spread over the widely dis-
tributed mucous lining of the bronchial tubes, and thus become cur-
able only in a partial degree, and after long and tedious treatment.
Hundreds of persons are now suffering from slight attacks of this
sort, who might be rid of the affliction in a week or a fortnight, but
who will either carelessly give it no attention at all, or resort to use-
less nostrums, until it has run tlirough its primary stages and invaded
the constitution, and will finally die of some of the forms of pulmo-
nary disease.
DISEASES OF THE THEOAT.
253
A Cold. — Influenza.
A SLIGHT attack of the disease about to be described, aifecting only
here and there a person, and lasting only for a few days, is called a
cold. When it affects a large part of the community at the same
time, lasting many days, or even weeks, it is then an epidemic, and
passes under the name of influenza. In this latter form, it sometimes
spreads over a whole country, and has at times, as in 1832 and 1894,
extended to nearly the whole civilized world. It often shows marked
severity in its progress, and leaves serious results behind.
. Symptoms. — A tingling, with dryness, and a sense of fulness in
the mucous membrane of the nose, are among the first indications of
an attack of this complaint. Sneezing is a common symptom. Soon
pain is felt in the forehead, and breathing through the nose becomes
difficult. The eyes are red and watery, the throat is sore ; there is a
dry cough, hoarseness, thirst, general lassitude, chills, and a desire
to get near the fire. The mucous membrane of the nose, throat,
windpipe, and breathing-tubes is inflamed, red, swollen, and some-
times painful.
In a short time, water begins to run from the nose and eyes, and
the cough becomes a little more moist. There is also a slight dis-
charge from the throat and tubes, which gradually increases, and, at
length, as the disease deelines, and becomes less acute, the expectora-
tion is thick and yellow.
Aching of the back and limbs, thirst, loss of appetite, flashes of
heat, and chills whenever the patient is exposed to air a little cooler
than he is accustomed to, are almost constant attendants upon the
disease.
Causes. — It is not always easy to say what the causes of this com-
plaint are. Frequently, it can be traced to an improper exposure to
cold or dampness ; but in a great majority of cases, especially when
it takes the form of influenza, the causes are not obvious. They
probably exist in some peculiar states of the atmosphere, and in a
depression of the nervous system.
The influence upon disease of the different degrees of density in
the air which surrounds us, and of other circumstances affecting it,
have not been much studied. Some valuable facts will be drawn
from this source before many years. The putting upon the body, or
taking from it, several tons of pressure every time the barometer rises
or falls, must have, of itself, no small influence upon its health. The
comparatively new science of Physical Geography, by spreading be-
fore us its interesting facts in regard to temperature, storms, atmos-
pheric currents, etc., is opening the way for the physician to learn a
great deal more about the causes of disease than he now knows.
Treatment. — In mild cases, only the most simple treatment is re-
quired,— such as remaining in the house for a few days, soaking the
254
DISEASES OF THE THROAT.
feet in warm water, taking a gentle sweat, drinking warm infusions
of flax-seed, mullein, slippery elm, or warm lemonade, and taking
only a spare vegetable diet. If the bowels be costive, some gentle
physic (34), (41) may be used, A laxative drink (132) will like-
wise be useful.
At the outset, especially when the nose runs water, a small dose of
atropia, ^ ^ grain, taken every two hours till the throat is dry, wiU
entirely arrest the disease at this point. The coryza pill found at
the druggists’ is a more valuable remedy still.
When the attack is more severe, sweating must be induced by de-
cisive measures. This may be affected by the spirit vapor-bath, or,
by putting the patient in bed, putting bottles of hot water to the feet
and sides, and administering warm drinks, and the compound tinc-
ture of Virginia snakeroot. Five drops every hour of the tincture
of veratrum viride will often cause very free perspiration, and will
reduce the inflammation upon the mucous surface.
An emetic is sometimes very useful. To produce vomiting, use
the powder of ipecac, ten to twenty grains, or the compound tincture
of lobelia.
It soothes the inflamed mucous surfaces very much to inhale the
vapor from half a pint of hot water, with five drops of tincture of
veratrum viride, or the same amount of the tincture of aconite root.
If the cough is severe, use the preparations recommended under
bronchitis and consumption.
In the latter stages of the disease, if there be debility, — as there
generally is, — quinia, iron, nux vomica, etc. (75), should be taken ;
or, to support the nervous system, the extracts of scullcap, and bone-
set, and the sulphate of quinia (81) will be found useful. At this
stage of the complaint, the diet should be more liberal and nourishing.
The patient should not venture into the open air until the unpleas-
ant sense of chilliness, peculiar to the disease, ceases to be produced
by exposure.
La Grippe.
This is a variety of influenza with which the world has become
well acquainted within the last few years. Its history is interesting
and its symptoms and results are severe and annoying. It is one of
the most severe forms of catarrhal disease of the nose or throat with
which we are acquainted. It owes its origin to a germ which found
its biidh in the filth and pollution of eastern Europe, and has visited
the globe with terrible ravages on several occasions since the Middle
Ages. It spreads by travelling the most frequented paths of com-
merce, and attacks those in a depressed state of health. The varieties
of la grippe are as numerous as that of any other disease. The catar-
rhal form is much like that of ordinary head influenza, only it is more
severe and prostrating; the bronchial assumes the influenza type, at
first, but soon attacks the lungs and sets up a severe, prolonged and
255
DISEASES OF THE THBOAX
harassing bronchitis ; the intestinal variety, besides producing the
general symptoms of malaise, fever, cough, severe aches and pains,
gives rise to a diarrhoea which lasts many days and is very debilita-
ting; the most common variety, however, is the rheumatic, which is
ushered in by chills, fever, muscular pains, coryza, cough and general
rheumatic pains. The characteristic feature of all of these forms is
the great prostration which accompanies these symptoms and the ob-
stinacy with which it clings to the patient.
The sequelae of the disease, though much exaggerated, are numer-
ous. The aged are often left infirm with heart weakness, the young
with lessened resistance to disease, and the middle-aged with chronic
coughs.
Many an. undiscovered disease has passed unnoticed under the dis-
guise of “ la grippe.” It has no doubt served as a broad mantle to
cover our ignorance of real disease and been made an easy refuge for
the complaining; still its affects at times cannot be over-estimated,
and death has not infrequently resulted.
T reatment. — The onset is to be met with large doses of quinine,
say 10 grains on retiring, by phenacetine and salol, 10 grains each,
taken with some hot lemonade on retiring. This latter may be re-
peated every three hours. The coryza is checked by small repeated
doses of belladonna, camphor and quinine, as found in the coryza
tablets bought at the druggist’s — one taken every two hours till the
throat is dry, then once in four to eight hours. The debility is to
be met by tonics.
Acute Inflammation of the Epiglottis.
This is the disease by which our country lost its most loved and
distinguished citizen, George Washington. This complaint was not
understood at the time of his death, — the intelligent physicians who
attended him supposing it to be inflammation of the windpipe. From
their very clear description of the symptoms, we now know it to have
been an acute inflammation of the epiglottis and glottis.
From the rapid inflammation of the epiglottis, water is effused into
this cartilage, so as to puff it up, and prevent it from shutting down
in the act of swallowing. The lips of the glottis are swollen from
the same cause, and brought so near to each other that air passes
through to the lungs with great difficuly, and unless relief is soon
obtained, the patient is strangled.
Symptoms. — The disease begins with a severe chill, accompanied
with some pain, and a sense of stricture or tightness in the upper and
fore part of the throat. There is cough, with difficult and sometimes
painful swallowing. These symptoms are soon followed by quick
and laborious breathing. Speaking aloud is from the first difficult,
and soon becomes impossible. As the complaint runs its rapid course,
the breathing grows more difficult, and death soon results from com-
plete strangulation.
256
DISEASES OF THE THKOAT.
Treatment. — Apply immediately to the paids a strong solution of
nitrate of silver. The solution should be of the strength of ninety
to one hundred and twenty grains to the ounce of soft water. It
should be applied every hour or two till the feeling of suffocation
subsides, and should be done with the laryngeal shower syringe,
though if this is not at hand the sponge probang may be used.
While this local treatment is being employed, liberal doses, from
five to twenty drops, of tincture of veratrum viride should be given
every hour, watching the effect, and discontinuing when the pulse
sinks too low.
Hot fomentations applied externally, and filling the room with
steam, as recommended in cases of croup, would be useful.
Mumps. — Parotitis. *
This disease appears most often among children ; but as it is not
confined to them, I have not placed it among their complaints.
Symptoms. — It begins with soreness and stiffness in the side of
the neck. Soon a swelling of the parotid gland takes place, which is
painful, and continues to increase for four or five days, sometimes
becoming very large, and making it difficult to swallow, or open the
mouth to receive food. After the fourth or fifth day the swelling
subsides, and disappears in from seven to ten days.
Both glands generally swell about the same time, but sometimes
the swelling appears in one only after it has subsided in the other,
and occasionally the swelling is wholly confined to one side.
When the swelling is great, there is heat, and sometimes fever,
with dry skin, quick pulse, furred tongue, constipated bowels, and
scanty and high-colored urine.
The affection is sometimes translated, as we say ; that is, in females,
the breast swells, and in males, the testicles become swollen and pain-
ful. This accident generally happens in consequence of taking cold
from some imprudence.
The disease is contagious ; that is, it is communicated fr^m one
person to another.
Treatment. — In mild cases, very little treatment is required.
Keeping the face and neck warm, avoiding exposure to cold and
damp, drinking warm infusions of balm, spearmint, or sage, and ap-
ply a poultice of flax-seed over the glands until the patient is fully
relieved ; or the compound powder of jalap, if there be costiveness,
is about all that is required. The diet should consist of rye hasty
pudding, or brown bread and sweetened water.
If the case be severe, and other glands swell, physic must be freely
used, leeches must be applied, and cooling lotions, or poultices.
Sweating must also be induced by the compound tincture of Vir-
ginia snakeroot, or by a vapor bath.
DISEASES OF THE THEOAT.
257
In young girls mumps often attack the ovaries and make the in-
valid a great sufferer for a few days ; the testicle of the male is simi-
larly affected at times. These complications call for soothing appli-
cations and rest in bed.
DISEASES of the CHEST
DISEASES OP THE CHEST.
(Also see Anatomy of the Lungs and Respiratory Organs.)
Consumption. — Phthisis.
As it was asserted a short time ago that the incurability of con-
sumption was an acknowledged fact, it is encouraging to know that
in many instances now we may effect a cure even under relatively
poor conditions, also that many persons have the disease and get
well of it without their knowledge. This is proved by the large num-
ber of cases that have come to autopsy for death from some other
cause and the diseases of the lung which has healed are discovered.
If the disease can be taken in hand early enough and the constitu-
tion of the person’s body protected from these ravages by appropriate
climatic conditions, good food, and possibly a little medicine, we are
justified in thinking that a favorable outcome will occur. It is neces-
sary to keep the weight of the person maintained and especially the
digestion more than good.
Marriage should be avoided by anyone afflicted with the disease,
as the bearing of children on the part of the woman will often cause
the disease to take a fresh start and the extra effort required by the
husband to maintain his family will do the same for him. It is only
fair to the friends surrounding the patient that precautions should be
taken to prevent the contraction of this disease from one whom they
are trying to help, as the disease is propagated by the increase of
the germ known as the bacillus of tuberculosis; we must destroy
this organism as soon as it is expelled from the person.
In the expectoration these germs are present in very large numbers
and in singing and coughing they are sent into the air to possibly be
inhaled and land on new soil for future trouble. The kiss of a con-
sumptive is very dangerous and even the use of toilet articles which
have been used to wipe the nose or mouth is dangerous until they
have been boiled. All expectoration should be received in articles
which can be burned before they become dried, and if the person is
confined to the house they may be received in an earthen vessel
which holds a solution of disinfectant such as carbolic acid, 1 part
of the pure acid to 20 of water, or corrosive sublimate, 1 part to a
1000.
It is for this reason that the boards of health of all the large cities
of the United States and Europe within the past few years have passed
ordinances prohibiting expectoration of sputum on the sidewalks, floors
of cars, at stations or public places, and the disease is now reported to
259
260
DISEASES OF THE CHEST.
them by physicians under penalty of fine in the same manner as small-
pox and diphtheria. Sunlight is another prevention, for this germ
cannot live in the rays of the sun and this is taken into account in
our treatment of the patient, as good air and sunlight are perhaps
the most important aids in helping us to get the better of the disease.
Methods of Examining the Chest. — Before speaking further of
consumption, I propose to do what has never been done, namely, to
instruct the general reader very briefly in the method of examining
the chest to learn the existence of disease. Perhaps this will be
considered a departure, in some slight degree, from my purpose to
make this entire book intelligible to the general reader. If so, my
reply is, that there are many school teachers, mechanics, masters of
vessels, and farmers, who have inquiring minds, and sagacity enough
to learn the physical signs of chest-disease, and to make them, in
many cases, practically useful ; and that even readers of little re-
flection cannot fail to comprehend a portion of my explanations.
Position of the Patient. — In performing percussion upon the
front of the chest, the patient should be required to sit in a square
position, with the arms hooked over the corners of the back of the
chair, and the head thrown a little back.
Instrument with which to Thump. — The index and middle
fingers of the right hand are to he brought together, into a line, and
used as the percussing instrument. The blow given with these is to
be smart and quich, rather than heavy.
Medium to Thump Upon. — Either the index or middle finger of
the left hand is to be pressed firmly upon the surface of the chest to
be percussed or struck, and thus used as a pleximeter.
Auscultation. — Listening for the purpose of hearing within the
chest the sounds produced by breathing, talking, coughing, etc., is
called auscultation.
Fig. 90. Fig. 91.
Instruments with which to Listen. — The naked ear is generally
considered best for hearing low and delicate sounds ; but for hearing
DISEASES OF THE CHEST.
261
loud and rough ones, it is not so good as the stethoscope, repre-
sented hy Fig. 90. A still better instrument is the double-eared
stethoscope, Fig. 91. It magnifies the sounds very much, and is apt
to confuse an examiner not accustomed to it ; but when the ear is
once familiar with it, the aid it affords is very valuable.
The examiner should pass from side to side, continually comparing
the sounds upon one side, with those upon the other.
The patient must be calm, and the examiner in no hurry.
Healthy 5ounds. — To become skilful either in percussion or aus-
cultation, the examiner’s ear must first be trained to healthy sounds.
These are best heard in the child, in whom they are louder than
in the adult.
In describing the healthy sounds in the different regions of the
chest, I shall refer the reader constantly to Figs. 92 and 93.
Clavicular Region. — This, in Fig. 92, is represented by 1, 1.
Upon thumping upon the collar-bones, the sound given out at the
breast-bone end should he veiy clear ; less clear in the middle ; and
dull at the shoulder end.
Subclavian Region. — This is represented by 2, 2, and lies be-
tween the collar-bone and the fourth rib, on both sides. It covers a
considerable portion of the upper lobe of the lungs. The sound
upon striking this place should he very clear.
Fig. 92. Fig. 93.
The Mammary Region, represented by 3, 3, extends from the
fourth to the seventh rib, on each side. In the upper part of this
region, the healthy sound is clear ; but at the bottom of it, on the
right, the sound is deadened by the liver ; on the left, by the heart.
262
DISEASES OP THE CHEST.
The Infra=Mammary Region, 4, 4, lies between the seventh rib
and the edge of the cartilages of the false ribs. On the right side,
the liver makes the sound dull ; but under the left side lies the
stomach, which is hollow, and the sound is generally quite loud.
In the Sternal Region, 5, 6, T, which covers the breast-bone, the
jound is generally clear.
The Axillary Region, 8, 8, is in the arm-pits. In this the sound
should be clear.
The Lateral Region, 9, 9, is immediately below the above, and
yields, likewise, a clear sound.
The Lower Lateral Region, gives a dull sound on the right side,
and on the left a very hollow one.
Fig. 93 represents the hack part of the chest. In looking at this,
we see the
Acromial Region, represented by 11, 11. In this space the sound
’s dull, but it has not much meaning.
The Scapular Region, 12, 12, covers the part occupied by the
shoulder-blades. It gives rather a dead sound.
The Intra=Scapular Region, 13, 13, lies between the shoulder-
blades, on each side of the back bone. If the patient’s arms are
crossed, and the head bent forward, a clear sound will be obtained.
The Dorsal Region, 14, 14, covers the base of the lungs, and, in
health gives, a clear sound.
Observation. — If, now, on thumping upon the chest, we find a
dull, dead sound in any spot where a clear one ought to be yielded,
we are to conclude that underneath there is not the usual quantity
of air ; but we cannot tell merely by percussing, whether tubercles
are deposited there, or the lung has become solid by inflammation,
or water has been poured out into the cavity of the pleura. This
point must be determined by auscultation, etc,, to be explained
gradually as we go along.
Auscultation of Breathing. — On applying the ear or the stetho-
scope to the chest, two sounds are heard which immediately succeed
each other, — the louder is produced by the ingoing breath, or in-
spiration ; the weaker by the outgoing breath, or expiration. These
sounds will be further explained as we go along.
Auscultation of the Voice and Cough. — The chest of a healthy
person speaking communicates to the ear no distinct sound, but only
a vibratory sensation, called, in technical language, the pectoral fre-
mitus.
Over the larynx and windpipe, the examiner may hear natural
pectoriloquy ; between the shoulder blades, in the space correspond-
ing to the roots of the lungs, natural bronchophony.
DISEASES OF THE CHEST.
263
Philosophy of Chest Sounds. — The fullness and clearness oi
sound upon percussion, depends upon the amount of air in the chest.
The sounds called breathing murmurs, are caused by the expansion
and contraction of the air-cells or vesicles, as the air passes in and
out ; hence they are called vesicular murmurs.
The friction of the air against the sides of the windpipe and large
bronchial tubes causes the blowing sound heard in those parts.
In children a larger amount of air enters the lungs, and the air
vesicles are expanded with more force ; hence their breathing has a
iouder sound, which is called puerile respiration. This kind of
breathing, heard in the grown person, is a sign of disease.
The lung tissue is a bad conductor of sound ; and the voice is ac-
cordingly heard only over those parts where large bronchial tubes
are near the surface ; heard elsewhere, it indicates disease.
Division of Consumption. — Consumption may be divided into
two kinds, the tubercular and the bronchial. The former has a con-
stitutional, the latter a local origin.
First Stage of Tubercular Consumption.
Physical Signs. — Dullness of sound on and under the collar-
bones. Inspiration shortened; expiration augmented both induration
and intensity. This dullness often first perceived in armpits, or at
base and back of lungs.
Occasionally a pulmonary, crumpKng sound. Dry, crackling rat-
tles.
The resounding of the voice increased at the top of the lungs.
General Symptoms. — A sense of weariness and languor.
Occasionally, slight, flying pains about the chest and shoulders.
A peculiar sensitiveness to the effects of cold.
Breathlessness on moving quick, or ascending a hill or stairs.
In many cases a blue lividity of the lips and roots of the finger-
nails, and coldness of the hands and feet.
Occasionally, in females, even at this early stage, a cessation of
the monthly turns. These usually stop later in the disease.
Observations. — The formation of tubercles almost always begins
at the top of the lungs. Laennec and others thoHght they appeared
oftenest on the right side first; Louis, Andral Watson, Sir James
Clarke, and others, believed they appeared more often on the left side.
Recent investigations show that they were all mistaken. Tubercles
appear first about as often upon one side as upon the other.
The pulmonary crumpling sound is caused by a mechanical ob-
struction to the expansion of the lungs. It is generally heard only
during the drawing in of the breath. The sound is like that pro-
duced by blowing upon very fine paper.
264
DISEASES OF THE CHEST.
Second Stage.
Physical Signs. — Marked dullness of sound on the collar bones,
and extending below them.
Inspiratory murmur diminished in duration and intensity ; expira-
tory murmur augmented in both.
In upper lobes of lungs, moist, crackling rattles, succeeded by
mucous rattles. Also bronchial respiration, or tubular breathing.
In lower lobes of lungs, puerile respiration.
Sounds of the heart heard under the collar bones.
Bronchophony heard in the same parts as bronchial respiration.
General Symptoms. — A quickened pulse; slight fever towards
evening, oftentimes amounting to quite high fever.
Great susceptibility to the effects of cold, and liability to take cold
easily.
Bowels generally costive ; oftentimes seat of pain.
The eye has a peculiar whiteness and lustre.
The skin and mouth become dry in the afternoon ; chills occur
about midday, followed by fever, during which the cheeks are flushed.
As the second stage advances to its close, a dry, burning heat
afflicts the palms of the hands and soles of the feet.
Night-sweats occur at this time.
Observations. — A hollow, elastic body, containing air, gives,
when struck, a clear sound. The dullness of sound on percussing
the chest, arises from the absence of air in the air-cells, — these
having been pressed together, or obliterated by the deposit of a mass
of tubercles. The destruction of these cells causes the cessation of
the respiratory murmur.
This stage of the disease is often accompanied by an inflammation
of the mucous membrane lining the air-tubes. The air, pushing its
way through the mucous secretions in these tubes, forms bubbles, the
bursting of which causes the rattle. The crepitant rattle is produced
by inflammation around the tubercles. The moist, crackling rattle
is caused by the softening of the tubercles.
The lungs, rendered more solid by the deposit of tubercles, become
better conductors of sound ; and this causes the beating of the heatt
to be heard as far off as under the collar bones.
Bronchial respiration gives the idea of air blown through a tube ;
cavernous respiration, of air passing into a large enclosed cavity.
Third Stage.
Physical Signs. — In this stage cavities are formed. If the cavi-
ties be small, and considerable tuberculated lung surrounds them, the
sound, upon percussion, is still dull.
DISEASES OF THE CHEST.
265
If the cavity be large, and near the surface, there is occasionally a
tympanitic sound with musical tone.
Sometimes a sound is heard like striking a cracked pot.
Gurgling; cavernous rattle; cavernous breathing; amphoric breath-
ing; now and then, metallic tinkling; pectoriloquy; cavernous cough.
General Symptoms. — Great loss of flesh, and weakness ; diarrhoea
and night-sweats ; swelling of the feet and legs ; sore mouth ; and
raising of matter with specks of tubercle in it like crumbs of cheese.
Observations. — The gurgling rattle is caused by air displacing
liquids, and the formation and bursting of bubbles. It resembles the
sound produced by blowing through a tube immersed in soap-suds.
Cavernous breathing is nothing more nor less than the sound pro-
duced by air, breathed in and out, entering and retiring from a
cavity. The air appears, sometimes, to one listening with the stetho-
scope, as if it were sucked into his ear during inspiration, and blown
back again during expiration.
Amphoric respiration is simply an augmentation of cavernous
breathing, and results, of course, from an increase of size in the
cavity.
In pectoriloquy, words uttered by the patient seem to pass through
the stethoscope into the ear of the listener. The cavity should be
empty, moderate in size, and have dense walls, in order to furnish
the best specimen of this sound.
Air suddenly driven backward through the windpipe, and out of
the mouth and nose, by smart raps upon the chest over a cavity,
gives the sound of the cracked pot. It is best heard when the pa-
tient’s mouth is partly open. The same sound is produced, on the
same principle, by locking the Angers of the two hands, and joining
the palms, so as to leave a small space or cavity between them, and
then expelling the air from that cavity, by gently striking the back
of one hand upon the knee.
Causes of Consumption. — The human constitution, as shown by
Liebig, in his profound work on Animal Chemistry, is governed by
two forces, the nervous and the vegetative. The former disposes the
particles composing the body to a state of motion ; the latter inclines
them to a position of rest.
In vegetative life there is motion in one direction only, so to speak;
that is, motion which tends to the opposite of motion, namely, rest.
In vegetables, whose life is wholly under this power, there is no waste;
for here, all ultimate particles, having once taken a place of rest,
remain undisturbed. In a tree, a layer of matter once deposited,
always remains. Hence there is growth as long as the tree lives.
There is no power to break up and destroy.
But in the animal body there is motion in two directions, or a
circuit of motion. Particles which under the vegetative force have
been put to rest, are perpetually being displaced by the nervous energy,
266
DISEASES OF THE CHEST.
and reduced to unorganized amorphous compounds, to be burned in
warming the system, or cast out by the several excretory processes.
So constant is the action of these two forces, that John Hunter
compared the human system to a whirlpool, into which the particles
of matter are perpetually poured, under the influence of the vegeta-
tive power, and out of which they are as constantly whirled by the
nervous force.
By a little reflection upon these antagonisms, the reader will see
that it is just when the vegetative force transcends the nervous, that
the body increases in weight, and acquires that state in which the
blood corpuscles abound, and the tendency, if to disease at all, is to
that of the inflammatory kind. It is the tonic condition of the sys-
tem. Nutrition is more rapid than destruction. New particles are
laid down faster than old ones are taken up. The body grows.
On the other hand, when the nervous force overmasters the vegeta-
tive, when the outward or centrifugal motion of the whirlpool prevails,
then it is that the body is attenuated, the blood thinned and made
serous, and the consumptive or atonic condition is established. Now.,
there is too much motion. The nutritive particles, instead of tending
to a state of deposit for the re-supply of waste matter, become fugi-
tive in their habits, perpetually fleeing, like convicts escaped from
prison. Introduce this power, in excess, into the vegetable kingdom,
and the matter deposited upon the tree, instead of remaining to swell
its bulk, would be driven off by the nervous force ; and the tree, in-
stead of growing, would be annually lessened, become sickly, and die
of consumption.
In Tubercular Consumption, the system is like a field deluged by
a flood ; nothing can take root. The repeated shocks of the nervous
battery sent to the absorbents so quicken them in their work of re-
moving waste matter, that they dislodge much which is not yet worn
out, and assist in casting out of the system not a little designed to be
used in its renewal. A healthy deposit is thus prevented, and nutri-
tion is at an end. The nutritive arteries, those little builders of the
human frame, are overmastered by the stimulated lymphatics ; the
constructive material is wrested from them, and borne beyond their
reach, and the body wastes from want of nourishment. The blood
becomes thin and watery ; and from the increased serous portion,
chiefly albumen, are deposited upon the lungs and other tissues the
albuminous tumors called tubercles.
Here is found the cause of that peculiar smallness of bone and
muscle, and thinness and tallness of person, so peculiar to consump-
tives. The absorbents, under the power of a very active nervous
system, take down “ the house we live in ” faster than the nutritive
arteries, confused liy the motion around them, can effect its recon-
struction. It is simply an unbalancing of the antagonistic forces,
which build and pull down our earthly tenement. The men that de-
molish are more numerous and better fed than the artisan builders
DISEASES OF THE CHEST.
267
It is this destnictively nervous force which gives to consumptive
persons their proverbial mental activity; which causes them often to
dazzle the world with the splendor of their gifts, and to bless their
friends with the warmth of their affections. They are usually the
choice spirits, the idols of their relatives, and the favorites of the com-
munity in which they live. Their mental movements, and the exer-
cise of their affections, are characterized by brilliancy and warmth.
Of all persons, they are best fitted to enjoy life, and to impart happi-
ness. Loving all, they are by all loved in return. They are speci-
mens of partially etherealized humanity, stepping lightly across the
earth, to whom friends passionately stretch out their arms, and em-
brace — tneir shadows !
These views will appear the more reasonable, if we consider that
in children the vegetative power is very active, while the nervous
energy is comparatively weak. The preponderance of the former
over the latter causes the rapid growth of children. The little arterial
builders work faster than the lymphatic demolishers. This explains
why so few children die of consumption.
But from the age of seventeen to thirty-five, when the vegetative
power is losing something of its extraordinary activity, and the nerv-
ous force is showing its highest capabilities, — then it is, as this
theory indicates, that tubercular consumption does its dreadful work,
— then, that the outward world of this physiological Maelstrom casts
upon the shores of mortality so many thinned, exhausted, and lifeless
human forms. More than three-fourths of all who sink under this
disorder die between the ages just named. The brain, between these
points of time, acquires its full size and force.
This disease prevails most, too, in those countries where an enlight-
«ned civilization gives to the nervous system its fullest development,
as in Great Britain, France, and the United States, and in those
where the nutritive process is most retarded by a relaxing climate ;
and it is scarcely known among those people who are but little en-
hghtened and have small brains, and among those who live in high
and invigorating latitudes. As the most enlightened, however, are
generally found in temperate climates, and those with the least culti-
vated brains in low latitudes, the rule is not perfectly explained by
facts ; yet it shows itself sufficiently to establish its validity, and to
afford another proof of my theory.
Bronchial Consumption.
The persons exposed to bronchial consumption are generally of an
opposite habit to those described above, — having the nervous force,
in health, well subordinated to the vegetative, the assimilation good,
and the blood well supplied with red globules. They have usually a
full habit and an active circulation. The absorbents, and other ves-
sels in the lungs, working in the midst of a large amount of caloric
268
DISEASES OF THE CHEST.
evolved by an energetic respiration, often take cold, which brings on
lung-fever and pleurisy, and these lay the foundation for the ultimate
destruction of the lungs. For the same reason, the skin of this class
of persons becomes diseased, and more often the inner skin, or mu-
cous membrane, and most often that portion of mucous membrane
which goes down into the lungs and lines the air-tubes. It is inflam-
mation of this which constitutes bronchitis, and which lays the foun-
dation for true bronchial consumption.
As that class of persons who are exposed to the tubercular form of
the disease suffer a general loss of carburetted hydrogen in its several
forms, colliquative diarrhoea, sweats, increased breathing, and all con-
ditions that carry fat out of the system, so those who suffer from
attacks of the bronchial type of the disorder are generally afflicted
with the opposite condition. They have too much carbon.
It is well ascertained that carburetted hydrogen, accumulated in
the system, acts as a poison. And that class of bilious persons who
are subject to this disease often have their excretions badly performed.
For this reason, carbonaceous compounds accumulate in the system,
and give rise to the symptoms of morbid poison circulating in the
blood. This led Dr. Madden to suspect the presence of such poison
in the blood of all consumptive persons. He saw the evidence of it
in numerous cases, and not distinguishing the one class from the
other, he inferred its presence in all.
Constitutional Difference.
The constitutional difference between the two forms of consump-
tion appears to be this : the tubercular type is usually attended, in its
origin, by a tolerably good state of the digestive function, in connec-
tion with bad assimilation ; wliile the bronchial form generally has
its foundation laid in connection with bad digestion, accompanied
with healthful assimilation. In the former case, the food is well di-
gested, the pabulum is properly prepared, but the nutritive arteries do
not use it for renewing the tissues. In the latter case, the digestion
is bad, the pabulum poorly elaborated ; but the re-constructive vessels,
under the control of a well-developed system of organic nerves, use
it to the best advantage. In the one case there are good hrick-makers,
and lazy brick-Zayers / in the other, the reverse.
It happens, however, that before the fatal close of the disease, tu-
bercular patients usually become afflicted, more or less, with bad
digestion, and bronchial patients with defective assimilation ; so that,
in the end, they present us with much the same class of symptoms.
Starting from opposite poles in life’s celestial sphere, they meet at
the culminating point of death, and disappear under identical aspects
of the heavens.
DISEASES OF THE CHEST.
269
Exciting Causes of Tubercular Consumption.
The preponderance of the nervous force being the state which pre-
disposes to disease, whatever unduly excites the nervous energy in-
vites an attack.
These causes relate, mostly, to the prolonged exercise of the intellect^
the passions^ and the sentiments.
Few are aware of the mischief done by excessive stimulation of
the mind during the most active period of life, — especially if the
muscular system be left half developed. Here is where ambitious
students commit great errors.
The constant plying of the mental powers, in the present modes of
educating children, leads to a dreadful abridgment of human life.
Better to train the bodily powers first, and let the mental culture
come in later time. He who would build a lasting structure must
lay a solid foundation.
The age in which we live abounds in the causes of excitement.
The world is trembling with excess of mental life. The pine trees
burned by the steam-engine are scarcely more numerous than the
human constitutions consumed by the train of thought it has set on
fire.
Nor are the passions and sentiments less exercised, or less destruc-
tive.
Briefly, the causes of consumption embrace all those things which
bring a destructive force against the digestive and assimilative func-
tions, as insufficient and improper food, debaucheries, night-watches,
sedentary habits, anxiety of mind, etc. ; and those which act injuri-
ously upon the breathing organs, as impure air, inflammation of the
lungs, pleurisy, measles, hooping cough, etc. ; and such as disturb the
sweating process, as insufficient clothing, sudden changes of temper-
ature, sleeping in damp sheets, etc. These exalt the nervous force,
or depress the vegetative, or inflame the mucous lining of the air-
tubes, or the substance of the lungs, or the membranous sack which
encloses them, so as to induce one form or other of consumption on
the principles I have explained.
The immediate cause of consumption we know, now-a-days, to he
due to a deposit of tubercles either in the neighborhood of the vocal
cords, the upper parts of the lungs, or, not infrequently, at the bases
of the same. These tubercles contain a germ called the Tubercle
Bacillus.^ which can only be seen with a high power microscope,
and then only after being stained with certain aniline colors which
they absorb. These little germs are of the rod-shaped variety of
bacilli, and appear under the microscope as little straight lines or
rods about inch in length. Their presence in the sputum of a
person means tuberculosis of some part of the air-passages ; when
they are associated with the presence of yellowish fibres (seen under
the microscope) they are a proof of the deposit being in the lungs
270
DISEASES OF THE CHEST,
proper. The examination of one’s sputum, therefore, in the early
part of any prolonged and suspicious cough, becomes an absolute ne-
cessity, since thereby one is made aware, in the earliest stages, of
this dreadful disease, and an opportunity offered of attacking it at once
in its incipiency. This modern discovery has given rise to much
experimentation in treatment with the aim in view of killing out the
germ. Robert Koch of Berlin announced to the world, a short time
ago, that he had discovered an agent, which he called Tuberculin,
that would eradicate these death-producing germs, but time has
shown his efforts to be unsuccessful as yet, although promising of
great results in the future. These germs are contagious in character,
so that v/e now can explain why many contract consumption in whose
ancestral blood there never existed any tubercular taint.
We know that husband may impart the disease to wife and mother
to daughter if only the system is in a receptive state to^offer a lodg-
ment to the germs. These tiny but most enduring bacilli retain
their life for an indefinite time in the midst of dust and other dried
secretions, so that a practical point is that all persons suffering from
tuberculous diseases should be exceedingly careful where they spit
and with whohi they sleep. To raise the sputum into small paper
cups wliich may be burned is a common and very prudent custom.
This discovery, while not disproving the old theory of heredity,
nevertheless explains many a case of acquired Phthisis, and clears up
many an old-fashioned theory.
These are indisputable facts from which the medical profession at
present hope to derive practical benefit by the discovery of some
germicide which may be applicable and safe for internal administra-
tion.
Can Consumption be Cured ? — In many cases it can. It maybe
cured, first, by the absorption of the tubercles. The celebrated John
Hunter shows, in his work on the blood, that the absorbent vessels
have a sort of elective affinity, hj which, they take up and remove “all
adventitious new matter, as tumors” (tubercles are albuminous tu-
mors), more easily “ than those parts which were originally formed.’*
Were this not so, an activity in these vessels equal to the removal of
tubercles would cause them to waste all the tissues, and aggravate
rather than cure consumption. Probably this does occur where
proper hygienic means are not used to quicken the excretions. This
hygienic treatment, to be spoken of hereafter, is not generally em-
ployed, — certainly not as effectually as it should be. Here is the
source of Laennec’s fatal remark, so often quoted and so widely en-
dorsed, that nature’s efforts towards effecting a cure are injurious,
and those of art are useless.” Laennec’s position cannot be true, if
Hunter’s statement is correct. If the absorbents, by an elective in-
stinct, take up adventitious matter rather than the natural tissues,
then the reason why they reverse this rule in consumption is, that by
a weakened state of the constitution, the ultimate particles are not
DISEASES OF THE CHEST.
271
well put together^ and are more easily taken apart than those of the
adventitious tubercular tumors ; and if we would restore these vessels
to their natural activity, we must improve assimilation, and knit the
unloving molecules into a firmer brotherhood. We must make the
fiesh hard, so that the absorbents cannot pick it to pieces. Do this,
and “nature’s efforts to effect a cure” will not “be injurious.”
A second form of cure is the reestablishment of the assimilative
function, the building up of the general health, the arresting of the
tubercular deposit, the reducing of tubercles already formed to an
indolent state ; and then, by a strict observance of the laws of health,
keeping them in that condition through life.
A third mode of cure is the healing of the cavities after the tuber-
cles have softened, broken down, and been expelled in the form of
expectoration.
A fourth method of cure is a change of tubercles to calcareous
matter. These calcareous tubercles, Laennec says, “are consequent
to tuberculous affections that have heen cured” And Andral, at one
time, hoped to learn how to effect cures by changing tubercles to
“ the calcareous phosphate.”
I have had several cases of cure by this last method, and have
quite a collection of calcareous substances which my patients have
coughed up, — one of which was raised in my presence by a lady
who was a few years before in hopeless consumption, but is now in
good health.
Treatment. — This should be of two kinds, local and general.
The local treatment of consumption is by the inhalation of vapors
and powders into the lungs. It has been practised, more or less, by
individuals, for many years, particularly in Europe ; but for some
unaccountable reason, the profession generally have never used it,
and do not know much about it. I had the honor, some years agq
to bring it freshly before the American public, in some articles writ-
ten for popular reading, since which time it has been rapidly gaining
public confidence, and is now attracting much attention. Conveying
the remedy directly to the diseased parts, it strikes the common-
sense mind as eminently reasonable and necessary.
I shall speak of inhalation, therefore, very earnestly, not as a
palliative of consumption only, but as far more, as a remedy. After
long and patient use, my experience allows me to say, that I know
it, in many cases, to be such ; and knowing this, I should be criminal
not to press it upon the public ; for it is the great multitude of
sufferers, pressing fast through the gate of death, who need to hear
words of hope.
Consumption a General Disease. — It is not denied that con-
sumption is a general disease, needing constitutional treatment ; but
it has also a local development in the lungs, first in the form of al-
buminous tumors, called tubercles, and then, after the softening.
272
DISEASES OF THE CHEST.
breaking down, and discharge of these, in the more formidable shape
of ulcerous cavities, which, beginning at the summit, devour the
lungs down to the base. Can it be reasonable to apply no remedy
directly to this local disease? Not so does our profession deal with
other local diseases. To an inflamed skin we apply poultices, cold
compresses, solutions of acetate of lead, nitrate of silver, etc. ; to
leprous or scaly affections, sulphuret of potash, bichloride of mer-
cury, zinc ointment, nitrate of mercury ointment, sulphur, creosote,
etc. ; to weak and inflamed eyes, sulphate of copper, sulphate of
zinc, nitrate of silver, and opium ; to chronic ulcers upon the skin,
tannin, pulverized rhubarb, opium, or cinchona ; and to an inflamed
throat, nitrate of silver and other articles. These are but specimens
of the thousand cases in which we use local remedies. Why, then,
when the mucous membrane, which lines the air tubes, becomes in-
flamed through all its branches, should we neglect, by the inhalation
of medicated vapor, to apply a remedy directly upon the whole in-
flamed surface ? Why, when tubercular matter is beginning to be
deposited upon the surface of the air cells, and of the small bronchial
tubes, should not the vapor go right to those parts, and cause, as it
would, the immediate expulsion of this offending and dangerous
matter ?
Uneducated common sense sees the reasonableness of these sug-
gestions at a glance. Many a person, with pulmonary disease, dies
of suffocation, not because there is not muscular strength to expel
the matter which is strangling him, but because the lungs below the
large pellets of mucus, which plug up the bronchial tubes, cannot be
inflated, and have therefore no means of driving out the offending
substance. Yet a proper medicated vapor, drawn in with the breath,
would either dissolve the mucus, or rouse up the expiring membrane
to cast it off.
If the reader were to place one end of a stethoscope directly over
the disease upon the breast of a person in the third stage of consump-
tion, and should then ask him to talk, the words spoken would seem
to rise up through the instrument, and enter, well articulated, into
his ear. This, in technical language, is called joectonYog'wy, — a word
signifying chest-talking. It implies a cavity in the lung. If now the
patient be asked to cough, a gurgling and splashing sound will be
heard. This denotes that the cavity is partly fiUed with fluid, which
is dashed about by the air explosively driven through it by the portion
of lung below. Here we have an excavated ulcer, with all its filthy
contents, composed of pus, mucus, serum, and dissolved tubercles,
lying in it day and night to aggravate its unhealthy condition. What
more reasonable, what more necessary, than that a soothing, alterar
tive, or astringent vapor should be drawn into this cavity, to cause
its sides to heal, and its absorbents to remove this fluid ? A surgeon
who should permit an ulcer upon the surface of the body to remain
in that condition without a local dressing would be deemed unfit to
practise his profession.
DISEASES OF THE CHEST.
273
Both in tubercular disease and in simple bronchitis, the bronchial
tubes almost always suffer some physical change. The mucous
membrane lining these tubes is generally softened. At other times
the tubes become enlarged through their whole length, so that many
of them, from the size of a quill, reach the bigness of the finger of a
glove. In still other cases, the straining produced by coughing
causes a tube to belly out at some point, forming a sack, which is
generally filled with mucus or purulent matter. At still other times,
a tubercle will press against a tube so as to flatten it and convert it
into a musical instrument, the air, as it is drawn laboriously through,
producing a high or low note, according to the size of the pipe.
These physical changes are all produced by causes which the inhala-
tion of a suitable vapor, at the proper time, would almost infallibly
remove. How strange that this remedy, — so simple, so effectual,
so easily comprehended, — should have been so little used !
Right at this vital point in the lungs, where the blood runs in a
ceaseless current, — where the whole of it goes every two minutes to
renew its vitality by contact with atmospheric air, — we have, in
thousands of cases daily occurring, inflammation with roughening or
softening of membrane, with its consequent harsh breathing ; we have
mucus, tough or glairy, to impede and interrupt respiration ; we have
tubercles in the hard or soft state, adding to the general embarrass-
ment, and not only lessening the vitality of the blood, but disturbing
all the sympathies of the system ; — and yet the practice has been,
and is, to attack these central disturbers of life only through the cir-
cuitous path of the stomach, lacteals, etc.
I have investigated faithfully the effects of the various substances
proposed for inhalation by European physicians, and have explored a
wide field of new remedies, not before used, several of which have
proved to have qualities of great remedial power.
The chief remedies I employ for inhalation are the following .
Alterative Inhalant, composed of iodine, six grains ; iodide of
potassium, twelve grains ; tincture of ipecac, one ounoO ; tincture of
balsam of tolu, six drams ; ethereal tincture of conium, one and a half
drams ; alcohol, half a pint. These are to be mixed. The dose is
one to two teaspoonfuls, to be inhaled ten or fifteen minutes, in
about a gill of hot water.
The ethereal tincture of conium is made by keeping a dram of
powdered conium in one ounce of sulphuric ether a week.
The above inhalant is used in the tubercular forms of consump-
tion, particularly that of the scrofulous kind, and in many cases of
bronchitis.
Expectorant Inhalant. — Take pleurisy root, half an ounce ;
squill, one ounce ; ipecac, two drams ; black cohosh, two ounces :
queen’s root, one ounce and a half ; American hellebore, two drams ;
diluted alcohol, one pint. Grind the roots, etc., and add the alcohol.
274
DISEASES OF THE CHEST.
Irdt the whole stand one week, shaking or stirring daily. Draw off
and filter through paper. Two teaspoonfuls make a dose, to be in-
haled same as preceding.
This is to he used when the cough is hard and dry, and the expec-
toration difficult. It makes the raising easy, lessening the soreness
of the chest, and the harsliness of the cough.
Soothing, Febrifuge Inhalant. — Take belladonna leaves, half an
ounce; black cohosh, two ounces; American hellebore, half an ounce;
poke-root, two drams ; aconite root, one ounce ; diluted alcohol, one
pint. Grind the roots, etc., add the alcohol. Let the whole stand
one week, stirring daily. Pour off and filter through paper. Dose,
one to two teaspoonfuls, to be inhaled as the preceding.
This is excellent in all cases where the skin is hot, the pulse
quick, the tongue and mouth parched, the chest sore, and the system
suffering during the whole or a part of each day, from a general
feverish condition. It is proper in all the forms of chest disease.
Astringent Inhalant. — Take of wild indigo, one ounce; catechu,
half an ounce ; Peruvian bark, one ounce ; golden seal, one ounce ;
diluted alcohol, one pint. Mix, and let the whole stand one week,
stirring daily. Drain off, and filter through paper. Add two drams
of creosote. One to two teaspoonfuls to be inhaled as preceding.
This is to be used when the expectoration is profuse and easy, un-
attended by fever, either in the latter stages of chronic bronchitis,
when the mucous membrane of the tubes is in a relaxed condition,
or, in the third stage of tubercular disease, for the purpose of con-
stringing, cleansing, strengthening, and healing.
Antiseptic Inhalant. — Take wild indigo, one ounce; belladonna
leaves, half an ounce ; diluted alcohol, one pint. Mix, and let the
whole stand one week. Pour off, and filter through paper. Then
add solution of chloride of soda two ounces. Dose, one to two tea-
spoonfuls, to be inhaled as the preceding.
This is used in cases of gangrene of the lungs, generally distin-
guished by considerable expectoration having a very fetid smell.
Anti=Hemorrhagic Inhalant. — Take witch-hazel bark, two
ounces ; black cohosh, four ounces. Grind, and add one pint of
diluted alcohol. Let the mixture stand one week, stirring daily.
Pour off, and filter through paper. Add to this two drams of creo-
sote. Dose, one to tliree teaspoonfuls, to be inhaled as preceding.
This is an excellent remedy for bleeding from the lungs. When
there is a tendency to bleed, it should be used for a long time. It
may frequently take the place of the above astringent inhalant.
For immediate relief give strong solution of salt water.
Object of Inhalants. — Being vaporized and inhaled, these articles
enter every air-cell throughout the lungs. Their object is to soothe
and mollify inflamed mucous surfaces, to reduce enlarged bronchial
DISEASES OF THE CHEST.
275
glands whiclx press upon neighboring parts and cause bleeding, to
stimulate the absorbents to take up and remove tubercles, to dissolve
tubercles out of the pulmonary tissue, to cause ulcerous cavities to
expel tbeir mattery contents, and to stimulate tbeir sides to take on
a healing process. They should be used from three to six times a
day, the inhalation continuing from ten to fifteen minutes.
Other Inhalants. — Great numbers of other articles have been
used, which I have not space to describe. I will mention, however,
that the following are sometimes employed with advantage : —
For an Expectorant Inhalant, take alcohol, four ounces ; tincture
of camphor, half an ounce ; tincture of tolu, two drams ; naphtha,
one dram ; benzoic acid, thirty grains ; oil of bitter almonds, four
drops. Mix.
For an Anodyne Inhalant, take alcohol, four ounces ; naphtha, one
dram ; benzoic acid, thirty grains ; chloroform, twenty-five drops ;
tincture of henbane, half an ounce. Mix.
For an Astringent Inhalant, take alcohol, four ounces ; naphtha,
one dram ; benzoic acid, thirty grains ; chloroform, one dram ; tannin,
eight grains. Mix.
Mode of Inhaling. — For inhaling these, a sponge is fitted into a
glass cup, to which a flexible tube is attached. A small quantity of
the mixture is poured upon the sponge, and the vapor arising is
drawn into the lungs through the tube.
To the expectorant inhalant may be added, occasionally, half a
dram of nitric acid.
These latter formulas are the principal ones used by those who
practice what is called cold inhalation.
A very common mode of inhaling volatile remedies is by saturat-
ing a little cotton, contained in a wire basket, with the desired oil or
fluid, and placing it over the mouth and nose. It is to be worn
throughout the day. Oil of peppermint, creosote, menthol, oil of
eucalyptus, etc., etc., are among the more common remedies thus
used.
A good inhaler can be bought of any dealer in surgical instruments.
Constitutional Treatment. — The rapid breathing in consump-
tion creates too much oxydation of the blood, — so much, that the
muscles, especially the heart, are usually of a bright red. To prevent
the patient from being literally burned up by oxygen, the blood
must be de-oxydated as fast as possible.
While there is too much of oxygen, there is, at the same time, a
deficiency of carbon. Hence the cold hands and feet, and the gen-
eral inability to bear frosty weather. The little nutritive arteries, in
these thin-blooded persons, stand shivering and torpid with cold, un-
able to perform their allotted function of nutrition. There is not
fire enough, and fuel must be had in the form of carbon. Hence one
of the advantages of cod-liver oil. This oil, too, as carbon, devours
276
DISEASES OF THE CHEST.
the oxygen of the blood, and prevents its destroying the patient.
This idea also explains the fact mentioned by Bennet and others,
that in their post-mortems they found the evidences of healed ulcers
in numerous persons who had been spirit-drinkers while living. And
Liebig helps the explanation by saying that alcohol, taken into the
system, circulates in a free state in the blood, and devours its oxygen.
To which I beg to add, that the malaria of intermittent and bilious
fever districts, has been pretty satisfactorily proved to be an instable
organic body, consisting of sulphur, carbon, and hydrogen, all of
which have an affinity for oxygen, and devour it in the system.
Consumption is not found in such districts.
As I am here treating of the chemical effects of remedies (and to
this test most remedies must finally come), I will mention that tar-
trate of antimony and potassa arrests the circulation in the pulmonary
arteries^ — which fact gives a complete and luminous view of its
power to prevent oxidation. But I am obliged to detract from its
merits, by stating that it also retards the circulation in the capillaries
of the system generally, and so hinders c?e-oxidation.
Phosphorus. — There is an article which has more recently pre-
sented itself to the notice of the profession, to which I wish to invite
special attention. I refer to phosphorus. This agent, for a time,
challenged our notice in the shape of phosphate of lime ; but we could
never feel sure that this article was dissolved in the fluids of the
body. We now use, and with far more marked effect, the hypo-
phosphites of lime, soda, potash, and iron. These are used in the
form of the syrup of the hypophosphites. The dose is a teaspoonful
before each meal. The effect unon tubercular disease is immediate
and gratifying.
Need of Phosphorus. — Cerebric acid contains nitrogen and phos-
phorus, and is the peculiar component of the brain and nervous sys-
tem. By combustion and the changes of oxidation in the brain, the
phosphorus of cerebric acid is converted into phosphoric acid ; so that
every act of the brain produces phosphoric acid. How rapid, then,
must be the consumption of the phosphoric element of the cerebric
acid, in that highly active and excitable state of the nervous system
which I have described as peculiar to consumption. And how neces-
sary, in order to save the brain from destruction, to meet this increased
demand for phosphorus, by introducing it into the system.
Mulder regards the fibrin of the blood as the carrier of oxygen; and
by this oxidation, the fibrin becomes converted into the biuoxide and
trioxide of protein, — its phosphorus and sulphur (for it contains
both) being converted into phosphoric and sulphuric acids. Adding
phosphorus and sulphur, therefore, as medicinal agents, would seem
to be the proper way to supply the fibrin with materials destructive
of its freight of oxygen.
It is well known that the salts of phosphoric acid are essential for
DISEASES OF THE CHEST.
277
the formation of azotic compounds, — compounds which are neces-
sary to sustain animal life. It should be remembered, too, as collat-
erally illustrating this fact, that the tribasic phosphates of potash, soda,
lime, and magnesia, play an important part in the growth and perfec-
tion of plants. They are always found in the seeds of the cerelia, and
no mature grains are produced where phosphates are absent from the
soil. For the production of abundant grain-crops, it is necessary
that these salts should exist in the soil, or be applied to it in manures.
It is known, moreover, that in all chronic diseases distinguished by
wasting of the tissues, a much larger quantity of phosphates is ex-
creted by the kidneys than in the normal state. Hence there is no
healtliful growth ; and the human organism, like the soil, exhausted
of its phosphates by successive croppings, brings nothing to perfec-
tion, and needs to have its drained salts re-supplied.
I cannot but call attention here to the inorganic substances found
in healthy human blood. According to very careful analyses, by
Schmidt :
1000 parts of blood-corpuscles, contain :
Chlorine 1.686
Sulphuric Acid 0.066
Phosphoric Acid 1.134
Potassium 3.328
Sodium 1.052
Oxygen 0.667
Phosphate of Lime 0.114
Phosphate of Magnesia .... 0.073
1000 parts of liquor sanguinis
and fibrin), contain :
Chlorine
Sulhuric Acid
Phosphoric Acid
Potassium
Sodium
Oxygen
Phosphate of Lime ....
Phosphate of Magnesia . . .
(serum
, 3.664
. 0.115
, 0.191
. 0.323
. 3.341
. 0.403
. 0.311
. 0.222
Iron is omitted. Now, I venture the prediction, that out of these
figures, mainly, in connection with those which represent the consti-
tuents of the saliva, the bile, the gastric juice, the pancreatic secretion,
and the organic compounds of the blood and tissues, are to be evolved
within a few years a correct and partially demonstrative system of
medication. In consumption, all the inorganic bodies represented by
the above figures, with the exception of oxygen, are deficient in quan-
tity. By reflecting upon the proportions of these several bodies, par-
ticularly upon the large amount of chlorine and soda in the plasma,
and of potassium in the corpuscles, the mind can hardly fail to obtain
useful hints. I have not hesitated to make one of these hints the
of a very free use of alkalies, — particularly in the form of
Sugar of Milk. — There is one other medicinal article which I deem
worthy to be made prominent, and to be placed side by side with cod
liver oil and the hypo-phosphites. I refer to sugar of milk. It belongs
to that class of non-nitrogenized articles which Liebig has denomi-
nated supporters of respiration. Its great affinity for oxygen is well
worthy to be taken into the account, in considering its value in con-
sumption. So great is this attraction, that, with ammonia and other
alkalies, it has the power of reducing some of the metallic oxides.
ground
bathing
278
DISEASES OF THE CHEST.
When taken into the stomach, it is rapidly absorbed into the blood,
which, being an alkaline fluid, augments its great de-oxidating power
to a considerable degree. It unites rapidly with oxygen after enter-
ing the blood, forming carbonic acid and water. A part of it, how-
ever, does not enter the blood in an uncompounded state, but is
changed in the stomach into lactic acid ; and this, in the blood, be-
comes an alkaline lactate. But the portion thus changed appears
also very useful; for Lehmann says: “We know of no substance
which could better act in the blood as food for the respiration, than
the alkaline lactates.”
Corroborative of these views is the fact that all those kinds of
milk, such as goat’s, ass’s, etc., which contain the largest amount of
sugar of milk, have at different times, and in various countries, ob-
tained a reputation for curing consumption. Goat’s whey, in which
this article abounds, and from winch it is largely manufactured, has
been celebrated for its virtues in this line. Ancel speaks of it as an
excellent remedy ; and Pereira says, “ Sugar of milk, in consumptive
cases and chronic diseases of the digestive organs, is a most valuable
aliment.”
One of the best forms of taking sugar of milk is that of a gruel,
which is quite palatable, and may be freely eaten by consumptive
persons.
Creosote, Guaicol, etc. — Modern researches having proved that
eonsumption, as well as maHy throat and other diseases are propa-
gated by germs or bacilli, as explained on page 269, medical investi-
gators have for a long time been seeking some agent that would
destroy these germs without at the same time injuriously affecting
the human system. A few years ago Dr. Robert Koch, a celebrated
German scientist, who had long been investigating the consumption,
cholera, and other microbes, thought he had discovered a lymph that
would destroy or at least counteract the consumption bacillus ; but
unfortunately it proved a failure. Creosote, carbolic acid, guaicol
and similar drugs kill the germ when outside the body, and for this
reason most therapeutists of to-day use these remedies in as large a
quantity, and for as long a time as the system will tolerate. At all
events, whatever may be the outcome of thecustom at present in
vogue, creosote certainly arrests the rapid proliferation of germ-life
in the lungs, improves the appetite and digestion, lowers the temper-
ature, and apparently helps the patient. The only offset to the use
of this class of remedies lies in the fact that one eannot thoroughly
disinfect the blood sufficiently to kill these germs completely. Creo-
sote made from beechwood, taken in three-drop doses with a wine-
glass of milk, after food, three times a day, is the usual form of
administration. This dose should gradually be increased till ten and
even twenty drops are taken at a time. The carbonate of creosote is
a more elegant and perhaps more effective form of the drug. This
medicine may also be procured in the form of capsules and pills.
DISEASES OF THE CHEST.
279
By Dr. Cyrus Edison’s recently discovered product of carbolic
acid, asepsin, it is claimed that seventy per cent of consumptive
cases can be cured. It can only be administered as a hypodermic
injection, however, at the hands of an experienced practitioner.
The Cough. — The best article I have ever used for this is the
“ Pulmonic Cherry Cordial.” I was five years in compounding this
article to suit me, and I believe it to be the very best cough prepa-
ration ever made. Dose, from one to two teaspoonfuls.
Pulmonic Cherry Cordial. — Wild-cherry bark, ground, 10 pounds
ipecac root, 20 ounces ; bloodroot, 24 ounces ; squill root, bruised, 12
ounces ; pulverized liquorice root, 5 ounces ; cochineal, bruised, 2
ounces; anise seed, 32 ounces; fennel seed, 8 ounces; orange peel,
16 ounces ; acetate of morphine, 12 drams ; alcohol, 8 gallons ; water,
8 gallons ; pulverized white sugar, 40 pounds ; sulphuric acid, 1
ounce.
Directions for making. — Grind all the articles to a* coarse powder
except those directed to be bruised or pulverized, and put them all
to the alcohol except the wild-cherry bark, the water, the sugar, and
the sulphuric acid. Let them stand one week, shaking or stirring
thoroughly twice a day. Then, having kept the wild-cherry bark two
days in a covered vessel, with water enough upon it to wet it through,
place it in a percolator, and run eight gallons of water through it.
Add this to the alcohol and other ingredients. Let the whole stand
tliree days longer, stirring as before, twice a day. Draw off, and fil-
ter through paper. Now add the sugar, and lastly the sulphuric acid.
The acid is intended mainly to improve the color, by acting chemi-
cally upon the cochineal. The color is a fine cherry red, tinged with
orange.
I have given the directions for making sixteen gallons — this being
the smallest quantity in which I make it. Any person ean easily
make the calculation for reducing the quantity. The assertion pre-
viously made that this is the “ best cough preparation ever made,” I
see no cause to modify in the smallest degree. Were it kept in
every apothecary shop, and were physicians to prescribe in pul-
monary complaints, adding a little syrup of squills or wine of ipecac
when a more expectorant effect is wanted, or a little morphine if
greater narcotism is sought, it would save them much trouble in com-
pounding cough syrups, and give them much more satisfactory re-
sults. I have compared its effect, again and again, with the best
other preparations in use, and I pledge my word that it will succeed
in twice as many cases as any other compound that may be chosen.
Let physicians try it; and I will be responsible for ever hair’s
breadth in which they find this proportion of successful results
abridged.
When a more quieting effect is needed, a little morphine may be
added to this preparation ; if a more expeetorant influence is required,
add a few drops of the tincture of veratrum viride. For the great
280
DISEASES OF THE CHEST.
majority of cases, it will be found to be right without any addition.
When this is not at hand, any of the preparations (108), (112), (109),
(113), (110), etc., may be used. Another good preparation is Dr.
King’s consumption cure.
Night Sweats. — The very best preparation for these sweats is a
compound of the oxide of zinc, one dram ; extract of conium, half a
dram ; to be made into twenty pills, of which one or two are to be
taken every night. The sponge bath also does much to check these
sweats, and vinegar baths (369). Atropia, of a grain on retiring,
and especially Agaricin, A grain, will cause the sweats to stop abso-
lutely.
Diarrhoea. — This is a most exhausting symptom in the latter
stages of consumption. The only remedy which has much effect in
controlling it is the tris-nitrate of bismuth. This should be given in
doses of thirty grains immediately after, or at the time of each meal.
These doses are much larger than used to be given ; but they will
do no harm. Given to this extent, I find the bismuth very effectual.
Iron. — This preparation, in some of its forms (316), (73), (159),
(102), is almost always needed in consumption. If the scrofulous
habit be strongly marked, give syrup of iodide of iron, in thirty-drop
doses, three times a day. It should be taken in a glass of water. To
the feeble administer Gude’s pepto-mangan in teaspoonful doses three
or four times daily. This is one of the simplest and most effica-
cious forms of iron we have.
External Irritants. — These are needed where there is much in-
flammation and soreness of the chest. Blisters should very seldom
be used. Croton oil, from two to half a dozen drops, rubbed over
the sore part, generally answers very well. Sometimes the mustard
paste, applied to the extent of producing redness, two or three times
a week, is sufficient. Nitric acid, reduced with water to a strength
a little above the strongest vinegar, answers a good purpose for
keeping up an irritation.
Atmospheric Inhalation. — It has been said by Laennec and others,
that asthma has sometimes the effect of arresting tubercular consump-
tion. Dr. Ramadge thought this was effected by an expansion of
the vesicular structure of the lungs ; and he reasoned that the same
expansion, by mechanical means, would secure a similar end. To ef-
fect this, he made his patients take long breaths through a tube con-
structed for the purpose.
It is manifest that the philosophy of atmospheric inhalation was
not understood by Dr. Ramadge, nor has it been by any of his fol-
lowers in this country.
Rokitansky tffinks the tubercular habit depends upon the excess
of fibrin in the blood ; and says that the reason of consumption being
arrested by pregnancy is, that this condition offers a mechanical ob-
DISEASES OF THE CHEST.
281
Stacie to the transmission of blood through the lungs, — thus pre-
venting its excessive oxidation, and keeping it in a venous state.
This destroys the fibrinous condition, on which he thinlrs tuberculosis
depends.
Now this is precisely what is done by atmospheric inhalation. The
trachea divides, on its entrance into the lungs, into two branches,
which again divide and subdivide until the tubes become smaller
than can be seen, each terminating in a minute air-cell. Over this
entire surface the air is intended to be brought into communication
with the blood for the purpose of oxidating it. By forcible inhala-
tion, the air-vesicles are inflated to the extent of their capacity, by
which means the extreme branches of the pulmonary arteries are so
flattened between these extended cells, as to be able to convey but a
small amount of blood, and but little is oxidated. This furnishes a
mechanical obstruction to the transmission of the blood, and secures
the defibrination of which Rokitansky speaks.
This is my view of the philosophy of atmospheric inhalation. The
benefit results, not from a larger amount of oxidation, as is generally
supposed, but from a smaller. Asthma does the same thing by pro-
ducing spasmodic contraction of the extreme bronchial tubes, and
preventing air from entering the cells.
The same end is gained in part by certain kinds of employment, as
glass-blowing, playing upon wind instruments, and the like. Writers
of distinction mention cases of recovery from incipient consumption
by a vigorous use of the lungs in singing. Dentists subject their
lungs to a similar process of expansion in the use of the blow-pipe ;
the writer has known several instances in that profession, in which
recoveries have taken place.
The Conclusion to which I come is, that atmospheric inhalation
may be used with great advantage in some cases, but should never
be resorted to except under the direction of a competent physician.
In a congested state of the lungs, with hsemorrhagic tendencies, or
with inflammation and soreness, it is well fitted to produce fatal
bleeding and is of course dangerous.
External Use of Water. — As a relaxation from severe exertions,
the ancients had frequent recourse to bathing. Those who contended
in the race, throwing the javelin, and wrestling, at Rome, plunged
into the Tiber while warm and panting with their efforts. That this
promoted prowess and physical endurance, none can doubt.
Louis, the great French authority on pulmonary diseases, lays
down several rules to be observed by consumptive patients, and par-
ticularly mentions cold bathing.
Few things give tone to the capillaries of the skin like cold water,
systematically applied. It rallies the powers of the constitution, and
improves assimilation. And by it another object is gained of scarcely
less importance. — that of guarding the system against taking cold.
282
DISEASES OF THE CHEST.
Those in the daily habit of applying cold water to the whole person
seldom suffer from colds and catarrhs ; they generally become har-
dened so as to endure the assaults of the elements.
Consumptive persons should generally use the sponge bath, with
cold water, if it can be endured, otherwise the tepid bath, to be fol-
lowed, in all cases with brisk rubbing, with a coarse towel. If a sense
of chilliness and discomfort follows the bath, a large portion of the
water must be squeezed from the sponge, so as to use but very little,
and the washing must be speedy, and the rubbing more lively than
usual, — beginning with tepid water, and gradually lowering the
temperature till it can be borne cold. A large teaspoonful of salera-
tus to each quart of water should be used.
Diet.
The diet, like all other parts of the treatment, must have reference
to the present condition of the patient. If the disease take the bron-
chial form, and rapid breathing, and other conditions calculated to
carry fat out of the system have not yet supervened ; or if the pa-
tient have thirst and hectic, the diet must be spare and simple, —
consisting chiefly of milk and farinaceous substances.
But in all cases where the disease is tubercular, or, being bronchial,
has reached the stage of emaciation, the very earliest moment at
which the fever can be subdued should be improved to build up the
patient with a generous diet. I have seen cases where the stuffing
sometimes resorted to for fattening turkeys for Thanksgiving would
seem to be almost justifiable. A good rule is to give the most gener-
ous diet that can be taken without disturbing the stomach, or increas-
ing the feverish symptoms. Animal food with a good quantity of
salt should be freely taken. Fat meats, if well received by the stom-
ach (and they generally are if taken cold}, are particularly useful.
The same is true of sweet butter and cream.
Out=Door Exercise. — Without exercise, as a general thing, the
consumptive patient will die. Exercise involves muscular exertion,
which is attended by the tension, compression, and greater compact-
ness of the muscles used. Extend your walk a little every day.
Stretch it out to the distant fields. Gather flowers from the top of
the hills and from the bosom of the valleys, and bring them home as
trophies of your victory.
If not able to begin with walking, ride as often as possible in a
carriage. The jolting of a vehicle will jog the blood along much
better than no exercise.
Horseback riding is still better. It combines, in some measure,
the passive exercise of carriage riding, with the active exertion of
walking on foot.
If the person who has only a small portion of the lung affected
and whose general health and strength has not failed, the employment
DISEASES OF THE CHEST.
283
of this advice for exercise cannot be too strongly put forth, as it means
the continual inhalation of pure air, caused by the exercise, but I
would not have a patient who has perhaps been greatly affected by
the disease, think that the way is not open to him for improvement.
He will of course not be able to exercise so strenuously, in fact, per-
haps the majority of cases do not require as much exercise as has
been advocated, provided however, they are placed in a 'position
where an abundance of fresh air is also available and no symptoms
appear which show that the strength is being called upon too vigor-
ously, such as the patient being unable to sleep at night and diges-
tive disturbances occur. But to the cases more advanced in the dis-
ease, it should be remembered that exercise will do more harm than
good and the whole question will be an individual one as no general
rules can be laid down for the patient. For as many hours and days as
is possible, the patient should be exposed to the direct rays of the sun
and protected from high winds. This may be attained on a high
elevation, such as the roof of the house, with a southerly exposure.
If it is so the patient can travel, some high, dry climate about 4000
feet in elevation is the best place, and in selecting this resort the thing ,
to be considered is the number of hours of the sunshine he or she will
be able to be subjected to. We do not consider now the degrees of
temperature, if the climate is free from moisture, as the patient can
be properly clothed and be allowed to remain out of doors all day.
The high altitude recommended is also beneficial because the patient
is obliged to take deep breaths, thus being obliged to exercise his
lungs.
Colorado and certain parts of Arizona and New Mexico in the
United States, portions of Switzerland which have an elevation of
four to five thousand feet above sea level, and San Moritz, abroad,
are examples of suitable places.
Before leaving the subject, and for the encouragement of those
affected, from the latest statistics at command, sixty per cent, of
early cases have been discharged well from the Adirondacks Cottage
Sanitorium.
Trudeau, the eminent authority of the United States, reports that
one-third of all the cases under his observation during the past seven-
teen years are well and that two-thirds of the earlier cases are cured
at the present time. Thirty years ago physicians thought that
only two per cent, of the cases were curable.
Sea voyages are now not recommended, with the dampness natu-
rally attending the trip, the lack of comfort on the steamer, the short
length of time consumed by the trip, its compulsory confinement and
the inability to eat nourishing food, if seasickness is present, all
weigh against this treatment; in fact, from what has been said, if
common sense is used a great improvement can be expected at, or
within a reasonable distance of, the patient’s home.
284
DISKASES OF THE CHEST.
Numerous other modes of exercise may be resorted to with advan-
tage. Dumb-bells, adapted in size to the strength of the patient,
and used with caution, are liighly serviceable. The battledoor, the
football, bicycle riding, pitching quoits, and the atliletic sports of the
gymnasium, all have their appropriate place. The greater the variety
the better, as by it all parts of the system are brought into play, and
both the mind and the muscles get the change which they need.
It is hard to impress patients with the importance of this subject.
Say wliat you will, they somehow or other get the idea that a mod-
erate amount of exercise, taken when they feel like it, is all that is
required. Fatal mistake ! Whatever the physician may do, the pa-
tient has a great deal to do for himself. He must strive to develop
Iris physical powers to the utmost. He must train himself as runners
and fighters do when preparing for their surprising feats ; for he is
running against the swiftest disease (or the surest winner) of our cli-
mate, and fighting with the elements.
If he regards life as not worth this exertion, of course he will not
make it ; but I beg him to consider that without it recovery will be
■ uncertain, and in many cases, impossible. Do as I have directed, and
if your medical attendant is skilful, the current of health will, in
many cases, begin to flow back to you. Life will renew to you its
policy of insurance, and multiply your days.
Drugs. — Tonics and bitters to help the appetite, iron, strychnine,
quinine in very small doses as a tonic; of the heart supporters digi-
talis may be given when indicated and used carefully under the
advice of a physician, cough sedatives of which, perhaps, the most
useful is one which may now be obtained at all drug stores, is the
Elixir of Terpin hydrate with heroin in the dose of a teaspoonful
four or five times a day.
Travelling: — Consumptive patients have generally been sent to a
southern climate. But where the case involves dyspepsia and affec-
tions of the liver, low latitudes are generally unfriendly. Liver com-
plaints are the bane of a southern climate, and a sallow complexion is
the inheritance of a southerner.
Tubercular persons, chilled by our northern climate, are sometimes
temporarily relieved by the warmer atmosphere of the south. But
the relief is only temporary ; for, having lost the power, as they im-
agine, to bear the frowns of our northern sky, they are dying, and
will die anywhere unless they recover this power. And the way to
retrieve a lost advantage over an enemy, is, not to retreat to a point
where recovery will be harder, but to meet him at once. If the con-
stitution cannot bear up against an enemy under the bracing of a
northern atmosphere, it will be still harder to do so under the wilting
of a southern.
After all, the objects aimed at should be change and travelling.
The exercise involved, the cougtant exertion required in getting from
DISEASES OF THE CHEST.
285
place to place, the agreeable sensations produced by the motion of
cars and steamboats, the ever varying change of sights and sounds,
and the constantly increasing stock of one’s ideas of men and things,
— these are what rally the constitution, and open anew the springs
of life.
Especially should all journeys^ for health be taken, if possible, with
an object in view. Let the consumptive start with the view of see-
ing the cave of Kentucky, the prairies of the West, the great lakes
of the North, the falls of Niagara, the fortress of Quebec, the Sague-
nay river, the doctor, who he has reason to think Avill cure him, —
anything which he is willing to make exertion to see, and that he is
sure his eyes will rejoice in beholding.
I have thus spoken of consumption more at large than of other
complaints, because it is the great disease of the world, and is in-
creasing with the advancement of civilization.
Acute Bronchitis.
This is an acute inflammation of the mucous membrane lining the
air-tubes in the lungs. It is generally quite a serious disease.
Physical Signs. — The sound upon percussion is generally good.
If there be any dullness, it is commonly in tbe lower and back part
of the chest. This occurs only in “Capillary Bronchitis.”
The breathing murmurs are sometimes more, sometimes less in-
tense than natural. Occasionally they are almost extinct.
In the early stage, sibilous and loud rattles.
In the more advanced stage, mucous rattle.
Now and then sub-crepitant rattle accompanies tbe inward-drawn
breath.
General Symptoms. — The disease begins with chills followed by
fever; tightness across the chest, difficulty of breathing, hoarseness,
loss of strength, costive bowels, and a quick and hard pulse. Water
runs from the eyes and nostrils, and there is a dry, harsh, croupy
cough.
After a few days, mucus begins to be raised. This expectoration
gradually becomes more copious, and is opaque, yellowish, or green-
ish, and occasionally streaked with blood. This mucus is very ropy
and adheres to the vessel.
There is more or less pain in tbe chest ; pain across the forehead,
which is increased by coughing; and a pale and anxious countenance.
In severe cases, the tightness across the chest is extreme, with a
sense of suffocation, causing the patient to call for the opening of
the windows. There is great difficulty of breathing ; a paleness and
lividity of the cheeks and lips ; a loud wheezing and rattling in the
throat, followed by cold sweat, insensibility and death.
In children the disease comes on like a common cold, attended by
286
DISEASES OF THE CHEST.
a sore throat, a great desire to drink,' but a disinclination to take
food. But two or three swallows of di’ink can be taken at a time
for want of breath. The phlegm is frequently vomited up spon-
taneously.
Observations. — The loud and sibilous rattles are produced by
similar causes, namely, the passage of air along tubes whose interior
is dry and rough from inflammation, or whose calibre is contracted or
altered in form by the swelling of the membrane, effusion upon its
inner surface of a tough, mucous substance, or a pressure upon its
external surface of tubercles, swollen glands, aneurism al tumors,
etc. The two sounds differ mainly in the key upon which they are
pitched, — the sonorous, or low-keyed, coming from the larger tubes;
the sibilous, or high-keyed, from the smaller, — just as the low notes
of an organ come from the large pipes, and the high notes from the
small ones.
Causes. — It is generally brought on by a sudden cold, by changes
of the weather, and by inhaling irritating substances. It is a second-
ary result, too, of scarlet fever, measles, small-pox, hooping cough,
and the remittent fever of infants.
Treatment, — In mild cases, give warm balm or flax-seed tea, hot
lemonade, or other similar drinks, — at the same time soaking the
feet in hot water, and, on retiring to bed, apply bottles of hot water
to the feet and sides, to produce sweating. If the bowels be costive,
some gentle physic, as rhubarb and magnesia, or salts and senna, may
be taken.
Chloride of ammonia in teaspoonful doses diluted in water and
citrate of potassium in 10 to 20 grain doses, or better still, a mix-
ture of
Chloride of ammonia, 3 drachms or teaspoonfuls.
Citrate of potassium, 4 “ “
Compound licorice mixture, 3 ounces.
Shake the bottle.
Take of the above, one teaspoonful diluted with water every three
hours.
In the case of infants, an emetic of wine of ipecac, or compound
tincture of lobelia, should be given, and followed jvith slippery elm
find flax-seed tea. The compound tincture of lobelia, with tincture
of veratrum viride, may be continued for a time as an expectorant.
In more severe cases, both of adults and children, an active emetic
is required, — perhaps the compound powder of lobelia is as good as
any. This must be followed with tincture of veratrum viride, in full
doses, so as to reduce the pulse at once, and keep it down to the
natural standard. This is one of the very best articles in this com-
plaint, and will generally very much lessen its violence and duration,
If there is much difficulty of breathing, the air of the room must
be kept moist, as recommended in croup.
DISEASES OF 'THE CHEST.
287
The room should also be kept warm, - — decidedly warmer than in
the case of other fevers.
A gentle perspiration should be kept up by small doses of com-
pound tincture of Virginia snake-root, and by frequently bathing the
surface, or else by tincture of veratrum.
Mustard should be applied to the, chest, and to the soles of the feet.
The cough may be managed by preparations (104), (106), (110),
freely given.
The diet should be confined to barley-water, toast-water, apple-
water, rice-water, and a solution of gum-arabic.
Chronic Bronchitis.
This is an inflammation of the mucous membrane of the air-tubes,
which continues a great length of time, without any sudden or re-
markable changes.
Physical Signs. — The percussion-sounds are similar to those of
acute bronchitis. When a bronchial tube is dilated, we sometimes
have dullness around the dilated part.
The breathing murmur is always accompanied by a mucous, sono-
rous, or sibilant rattle, — sometimes by a subcrepitant.
When dilatation of the tubes exists, the intensity and duration of
the sound of the ingoing breath is decreased^ — of the outgoing
increased.
In this state of the tubes, we also have cavernous breathing, bron-
chophony, sometimes pectoriloquy, and bronchial or cavernous cough.
General Symptoms. — A cough is generally present, which is in-
creased in wet weather, and by every slight cold. This comes on in
paroxysms ; is generally worse in the morning ; and is relieved by
raising freely. The matter raised is generally yellowish, but some-
times whitish and sticky; and in the latter stages is thick, and
sometimes very much like that of consumption. Indeed, the disease
often ends in bronchial consumption.
Remarks. — The breathing is bronchial or cavernous when the
dilated portion of the tube is empty ; if it contain fluid, the
mucous rattle will be heard.
Dullness on percussion will exist if a dilated tube press upon the
surrounding portion of lung so as to condense or make it solid.
Dilatation of the tubes occurs only in chronic bronchitis of long
standing. Its physical signs are much like those of a cavity in ad-
vanced consumption. The examiner may learn to distinguish them
by considering that in consumption, dullness precedes the cavity., while
in bronchial dilatations, the cavity precedes dullness.
The dilatation or swelling out at some point of a bronchial tube
is caused by obstructions to the passage of air through it, — just as
288
DISEASES OF THE CHEST.
an India-rubber tube, partially closed up at a given point, will bulge
out just in front of the obstructed place, when air is forcibly blown
through it, and just as the left ventricle of the heart enlarges when
the blood is obstructed in its passage through the aortic valve.
Causes. — It often occurs as the result of acute bronchitis, and
also of measles, hooping-cough, etc. But taking cold, and damp and
changeable weather, are more frequently its causes. It most often
follows chronic inflammations of the throat, which, being neglected,
gradually creep down the windpipe into the tubes, and become very
obstinate in their character.
Treatment. — Medicinal inhalation is one of the best remedies for
this complaint. The inhaling powder has, in many cases, great
efficiency. The dose is about what can lie on a ten-cent piece. It
should be used once a day, in an instrument represented in the cut.
This instrument I had constructed for my use. It consists mainly
of a glass tube and a receiver, —
the latter being something like a
tube-vial, pierced with fine holes
around the lower end. The pow-
der is poured into the receiver,
which is placed in the larger tube,
and twirled between the thumb and finger while inhaling.
When the powder cannot be easily got down into the tubes in the
lungs, — as often happens, — the inhalation of medicated vapor will
do better. If the expectoration be difficult, the expectorant inhalant,
described under “consumption,” should be used; if the expectoration
be too profuse and free, the astringent inhalant must be taken.
The cough preparations recommended for consumption, also (113),
(112), will be the proper ones in this complaint.
The daily alkaline bath, and brisk friction, are particularly service-
able.
Out-door exercise is almost as necessary in this disease as in con-
sumption.
Enlargement of the Air-Cells. — Emphysema.
This disease consists in enlargement of the air-cells, the oblitera-
tion of their vessels, and the wasting of their walls.
Physical Signs. — Thumping upon the chest gives a clearer and
louder sound than natural, — one which is tympanitic, or drum-head
like.
The murmur of the ingoing breath is diminished both in duration
and intensity, — of the outgoing breath, it is increased.
Dry, crepitant rattle attends the ingoing breath only; occasionally,
sibilous rattle.
DISEASES OE THE CHEST.
289
General Symptoms. — HaHtual shortness of breath, and very
great difficulty of breathing, occurring in paroxysms, which cause
the patient to rush to the open window for air.
There is generally a cough, and the matter raised is frothy, liquid,
and mucous, or watery.
The face has a peculiar dusky color, and the countenance an anx-
ious, melancholy expression. The nostrils are thick, and the lower
lip full. The muscles of the neck are large, and the gait of the pa-
tient is stooping. The strength is wasted in proportion to the diffi-
culty of breathing.
Emphysema tends to produce disease of the heart, Bright’s disease,
and venous congestions in the head.
Observations. — The tympanitic sound is caused by the increased
amount of air in the cells.
The air-cells have lost their elasticity, the air, in a great degree,
remains in them, — not passing in and out, — hence the absence of the
vesicular murmur.
The crepitant rattle attends the ingoing breath only, and is sup-
posed to arise from the expansion of the lungs which are in a drier
state than natural. It has been compared to the sound producd by
blowing into a dried bladder.
Treatment. — To whatever extent the air-cells are destroyed, to
that extent, of course, the disease is incurable. It may, however, be
palliated and relieved to a great extent.
Generally, bronchitis exists in connection with emphysema ; and
when this is found to be the case, the remedies for that disease must
be employed. (370) often is curative.
The inhalation of tincture of stramonium, in one or two teaspoon-
ful doses, the same as the alterative inhalant is used, will be useful.
To be taken internally, an excellent preparation may be made by
uniting one dram of etheral tincture of lobelia with two drams of
tincture of ipecac, and two ounces of ammoniac mixture. The dose
is one or two tablespoonfuls. Half-grain to grain doses of extract of
cannabis indica are excellent to relieve the difficulty of breathing.
The diet must be very carefully regulated, as overindulgence at the
table aggravates the symptoms.
Change of air is often highly beneficial ; but it is impossible to
predict its effect beforehand in each individual case.
Swelling of the Lungs. — Hypertrophy of the Lungs.
This can hardly be regarded as a disease. It generally takes place
in but one lung, and is the result of the inaction of the other. Thus,
when one lung is diseased, the other has to do the work of both ; and
being overworked, it enlarges, as the heart or an arm does when very
much exercised.
290
DISEASES OF THE CHEST.
The only treatment required is to eat sparingly, and exercise with
great moderation, so as not to increase the rapidity of the breathing.
Pulmonary Apoplexy.
This is generally the result of a disease of the heart, particularly
of the mitral valve.
Physical Signs. — Percussion yields a clear sound, except where
the engorgement of blood is large, and near the surface, — in which
case, it is dull.
The sound of breathing is feeble or absent over a limited space.
Bronchial breathing is heard in some places, and bronchophony in
part, in the same regions.
Mucous rattle is also heard.
Observations. — In this disease the small air-tubes and air-cells are
the seat of bleeding ; and the blood becoming coagulated here, closes
these vessels against the entrance of air. This explains the feeble-
ness or absence of the breathing murmur.
The fluidity of blood in the immediate vicinity gives rise to the
mucous rattle.
General Symptoms. — These are, difficulty of breathing, tightness,
and dull pain in the chest. The mucus raised is tinged or streaked
with blood. The blood raised is darkish, and dirty-looking. This
last symptom, the dirty look of the blood, is peculiar in this disease.
Treatment. — The most important remedy is dry-cupping upon the
chest. This will often arrest the disease at once. Counter-irritation
by croton-oil is also useful. A free movement of the bowels by a
preparation containing croton-oil, or elaterium (31), (33), has an ex-
cellent effect.
Air in the Chest. — Pneumothorax.
This disease consists in the presence of air in the cavity of the
pleura. Generally, there is also water in the pleural sac at the same
time ; the water, being the heavier fluid, occupying the lower part of
the cavity, and the air the upper part.
Physical Signs. — Tympanitic or drum-like sound over the upper
part of the side. Dull sound over the lower part. Breathing mur-
mur diminished or suppressed. Amphoric breathing. Metallic tink-
ling.
General Symptoms. — Great oppression of the chest, and difficulty
of breathing ; generally attended by palpitation of the heart, and fre-
quently by severe pain under the breast-bone, on the affected side.
The patient generally has to remain in the sitting posture, and can-
not lie an instant on the sound side,
DISEASES OF THE CHEST.
291
If, on percussion, one side of the chest sounds louder than the
other and the breathing murmur is heard distinctly on the side which
gives only a moderate sound, and is not heard at all on the loud-
sounding side, we may he sure it is a case of air in the chest.
Observations. — The metallic tinkling is like the sound produced
by dropping a pin’s head into a metallic dish, or like the distant tink-
ling of a sheep-bell, or the gentle pulling of the string of a violin.
It is supposed that when the fluid in the cavity of the pleura hap-
pens to be higher than the orifice, the air, when it enters at each
in-drawn breath, forces its way up through the fluid, in the shape of
bubbles, and, bursting at the surface, gives the tinkling sound. This
sound is sometimes produced, too, by the falling of drops of liquid
from the upper part of the cavity, upon the surface of the fluid.
The amphoric breathing is like the sound produced by blowing
obliquely into an empty cask. One writer says he heard the same
sound Avhen out shooting on a rough day, produced by the wind blow-
ing sideways into the gun-barrel.
Treatment. — I would recommend the use, two or three times a
day, of the antiseptic inhalant, mentioned under the head of con-
sumption.
To this should be added dry-cupping over the whole chest, which
generally gives great relief. Blisters may also be used.
Sweating must be encouraged in the manner recommended under
acute bronchitis.
For the difficulty of breathing, give half-grain doses of cannabis
indica, or five-drop doses of tincture of aconite, or one-sixth of a
grain doses of svapnia. Extract of belladonna, or of stramonium, is
also worthy of trial.
Water in the Chest. — Hydrothorax.
This disease consists in a collection of water in the cavity of the
pleura.
Physical Signs. — There is a dull sound over the effusion.
The breathing murmur is diminished, and gradually disappears
altogether over the space occupied by the effusion.
Bronchial breatliing is heard in the same part.
When the amount of fluid is small, egophony is heard in the mid-
dle regions of the chest.
Bronchophony is heard when the effusion is larger.
General Symptoms. — Either upon lying down, or using active
bodily exercise, the patient finds his difficulty of breathing increased.
When in bed, he lies with his head and shoulders raised, which, by
causing the fluid to settle at the bottom of the cavity, prevents, in a
measure, its pressure upon the lungs, and gives him a little rest.
292
DISEASES OF THE CHEST.
His sleep is interrupted by sudden starts with alarm and terror. The
pulse is hard, the thirst great, the urine scanty and high-colored, and
has a sediment. After a time the feet swell, the face is pallid and
livid, and the countenance expresses anxiety and alarm. There is a
short, dry cough.
When the quantit}^ of fluid in the chest becomes large, the patient
cannot lie down at all, and only gets short and disturbed naps in the
sitting posture.
Of all the symptoms, the starting m sleep is the most certain sign
of the disease.
Causes. — In some rare cases, this may occur as a primary disease,
— that is, as a disease not dependent upon any other as its cause.
The greater number of cases, however, are secondary. They arise
from organic disease of the heart, or liver, or stomach. Inflammation
of the pleura is a very frequent cause.
A plethoric, or full state of the system, predisposes to this com-
plaint,— particularly in those persons who indulge freely at the
table.
It may arise, too, from the striking in of skin eruptions ; from the
free use of liquors ; and from frequent excessive bleedings or purg-
ings.
Treatment. — Dry-cupping is a valuable remedy, and should al*
ways be practised.
The chest should be painted with the tincture of iodine, and a
good degree of substantial soreness be kept up.
The internal remedies are purges (31), (14), (30), and diuretics
(128), (129), (130), (131) when the patient is not very weak.
The iodide of potassium, in doses of five or six grains, once in
three or four hours, is an excellent remedy. The following is a good
form of taking it: iodide of potassium, one ounce; fluid extract of
pipsissewa, two ounces ; water, half a pint. Dose, one teaspoonful.
The skin should be bathed and rubbed daily, three or four times,
with much friction. Tapping the chest should be done when the
fluid persists any length of time, otherwise a simple hydrothorax may
become a doubly serious empyema or pus in the chest.
Pleurisy. — Pleuritis.
Pleubisy, or pleurisy fever, as it is sometimes called, is an in-
flammation of the pleura, or the membrane which lines the chest,
and, at the same time, is folded back so as to cover the outer surface
of the lungs.
The pleura, as is elsewhere explained, is a short sac or bag, whose
inner sides are kept moist, so that they may slide easily upon each
other as they are moved by the alternate contractions and expansions
of the lungs in the act of breathing, and whose outer sides are made
to grow, — one to the inside of the chest, and the other to the out-
side of the lungs.
Diseases of the chest.
293
Pleurisy and lung-fever, then, must be kindred diseases, and exist,
more or less, together. In truth there is almost always some affec-
tion of the pleura in lung-fever, and some affection of the lungs in
pleurisy. The pain in lung-fever is owing to some inflammation of
the pleura ; and the appearance of the rusty-colored phlegm in pleu-
risy indicates that the lungs have been reached by the inflammation
of the membrane which covers them.
Physical Signs. — Flatness on percussion, at the lower part of the
chest, which ascends as the effusion of water increases.
If the effused fluid is not great, there is puerile breathing at the
top of the lung.
Friction sound is heard occasionally in first stage of disease.
Egophony is heard when the amount of fluid in the pleura is
small.
As the amount of water increases, bronchophony appears.
General Symptoms. — This disease is most frequently introduced
by iMverings^ which are soon succeeded by liigh fever, with a pecu-
liarly hard, resisting pulse; sharp, stabbing pain in the side, — gener-
ally just below the nipple, but sometimes extending to the shoulder,
arm-pit, and back ; hurried and interrupted breathing ; and a short,
dry cough.
The pain is greatly aggravated by motion, coughing, or an attempt
to take a long breath. It holds the patient under constant and
powerful restraint. We find him lying upon Ifis back, or his well
side ; his countenance full of anxiety, — fearing to move, cough, or
even breathe needlessly ; and often crying out from the keen torture
these necessary acts inflict in spite of all his caution.
At a more advanced stage, when the tenderness has somewhat
abated, he will prefer to lie on the diseased side, as this leaves the
healthy lung more at liberty.
Observations. — The first effect of the inflammation of the pleura
is to dry up the moisture with which its inner surfaces are lubricated,
or made smooth and slippery. As a consequence, these surfaces be-
come rough, and rub harshly upon each other, and produce a sound,
in the early stages of pleurisy, like that of rubbing two pieces of wet
leather together. It may be imitated by rubbing the finger back and
forth upon a table. It is sometimes a creaking noise, like that of
new shoes.
As the disease advances an important change takes place in the
state of things. Instead of an unnatural dryness, a watery fluid is
poured out copiously from the inflamed surfaces of the pleural sac.
This is called the period of effusion. This generally, though not al-
ways, relieves the pain. But, by compressing the lung, causes dan-
gerous difficulty of breathing.
The air-cells are compressed by the effused fluid, and are not
penetrated by air. Hence the absence of the breathing murmur.
294
DISEASES OF THE CHESt.
The pouring out of water between the layers of the pleura, com-
presses the lung, and removes it from the walls of the chest. Hence
the dullness or deadness of sound upon percussion.
When listening with the stethoscope, the voice of the patient
sounds feeble and interrupted, like the bleating of a goat, and is
hence termed, egophony, or goat-voice.
This peculiar voice is heard only when the effusion of water has
been moderate in quantity, and only a thin layer of liquid lies be-
tween the ribs and lung. It is caused by the voice passing over tliis
thin layer, which is thereby thrown into vibrations., or wavy, quivering
motions. When thus agitated, the fluid reacts upon the voice,
making it sharp and tremulous.
When the effusion has become large, these effects cease ; but an-
other sign then shows itself, and distinguishes pleurisy from the
healthy state, and likewise from the solid, hepatized state of the
lung in lung-fever. It may be discovered thus :
If the hand be laid flat upon the chest of a healthy person, while .
he is speaking, a vibration or thrill will be left. If, in like manner,
the hand be laid upon the chest of a person having lung-fever, with
hepatized lung, this thrill will be found still more perceptible. But
when the hand is placed over the place of watery effusion on the
chest of a person having pleurisy, there will be discovered, when the
person speaks, no thrill whatever. The absence of this thrill, then, is
one of the very best signs of pleurisy ivith effusion.
Persons recover from pleurisy sometimes very rapidly, before effu-
sion has taken place. It is then said they have had an attack of dry
pleurisy. When liquid has been poured out, even in considerable
quantity, it is sometimes reabsorbed, and the patient recovers per-
fectly. In other instances, it compresses the lungs, interferes seri-
ously with breathing, reduces his strength, and he sinks rapidly.
Treatment. — Pleurisy has been divided for description and treat-
ment into three stages, following the natural events of the inflamma-
tion. The first stage comprises the period from the first onset to the
time when effusion commences. The second stage, or stage of effu-
sion, extends to the time when the liquid begins to diminish ; and
the third stage consists of the period occupied by the absorption of
the liquid.
Should the quantity remain stationary or diminish very slowly
after the lapse of two or three weeks, the disease becomes chronic.
The indication for treatment during the first stage is to arrest the
progress of the disease, to diminish its intensity, to limit the amount
of morbid products, and to relieve suffering.
If the patient is robust, has a hard, frequent pulse, accompanied
with extreme pain and fever, blood-letting is indicated. The abstrac-
tion of ten to fifteen ounces of blood will give great relief and
diminish the intensity of the attack ; but if the patient is not seen
early, and is of a feeble constitution, some other measures should be
DISEASES OF THE CHEST.
295
substituted for it. The mass of blood may be lessened by saline
cathartics, such as the sulphate of magnesia, or the bitartrate of
potash in combination with jalap.
The effect of a full dose of Epsom salts is equal to the abstraction
of a pint of blood from the system. Depletion is obtained this way
without the impoverishment of the blood.
Tlie frequency and force of the heart’s action may also be affected
by the nauseant sedatives, such as tartarized antimony and ipecacu-
anha, and by the direct sedatives, such as the tincture of aconite and
of veratrum viride ; therefore, if blood-letting is contra-indicated, the
first thing to be done is to give the sulphate of magnesia, and follow
it with some diaphoretic like (130), to alleviate the painful stitch in
the side and to tranquillize the system.
It is well to administer salicylate of soda in 10-grain doses every
three hours till a little ringing is heard in the ears, then once in four
hours. This drug increases the action of the skin and kidneys and
overcomes the rheumatic element present in most if not all pleurisies.
The diet should be dry, all liquids being excluded, that the abstrac-
tion of water from the chest may be favored.
Nothing gives so much and such immediate relief to pain as a
subcutaneous injection of morphine. Aconite also is a valuable
sedative in this stage. It may be given in half or whole-drop doses
every fifteen minutes for two hours ; then afterwards a drop, to be
repeated hourly till some impression is made upon the heart’s action.
Smaller doses are to be given if the pulse becomes feeble.
In the second stage, if the acute symptoms have yielded to treat-
ment, as they usually do, the object of treatment is to promote the
absorption of the fluid. This is done by the judicious use of saline
cathartics and by diuretics, for the bowels and the kidneys are the
natural pumps of the system.
The application of counter-irritants is also of use for this purpose,
such as the tincture of iodine, and small blisters, which are to be
allowed to remain on till vesication, and then the blister is to be
dried up and a new one applied. If at any time during this stage
the effusion is rapid and excessive, so as to endanger life, it is to
be drawn off by puncturing the chest between the fifth and sixth
ribs on the side with a small trocar, and the fluid is to be drawn off
by suction.
Convalescence commences when the liquid begins to be absorbed ;
and active medication should then cease, and that course should be
pursued which will lead to the restoration of the general health.
This is done by tonics, a nutritious diet, and other hygienic means.
If the effusion ceases to be absorbed or the process takes place very
slowly, then that state of things exists which is called chronic pleu-
risy. Then the main objects of treatment are to effect the removal
of the fluid, and to develop and sustain the powers of the system.
Under these circumstances, it is better to discontinue remedies which
act upon the bowels and kidneys, at least for a time, and try general
296
DISEASES OF THE CHEST.
treatment. This consists of tonics, stimulants, and general exercise
in the open air, and with this the surgical removal of the fluids from
the cavity of the chest.
The operation is now so much improved, and is so safe and simple
and attended with so little pain, that it has become an every-day
practice, and an operation which was only resorted to as an extreme
measure to save life, is now admissible whenever the pleural cavity
remains filled with liquid, after only a brief trial of the remedies
assigned to promote absorption.
Lung Fever. — Pneumonia.
This disease, by common usage, has been called a fever; but by
physicians it is reckoned as one of the inflammations. It is inflamma-
tion of the lungs or lights ; and whatever fever there may be results
entirely from this local inflammation.
For the purpose of more clearly describing this complaint, it is
found convenient to divide it into three stages, or degrees of progress.
First Stage. — This is called the stage of engorgement. The lungs
during this stage are engorged or crowded with blood. If we could
inspect them, we should find the inflamed portioji redder., thicker., and
heavier than usual. We should find them weaker, that is, more
easily torn than in the natural state ; with less air in them, and con-
sequently crackling less upon pressure, — yet not entirely destitute
of air and crackling, and not so heavy as to sink in water. Eapping
upon the chest at this period gives out a flatter, duller, or less hollow
sound than usual. On applying the stethoscope, we hear less of the
natural rustling sound of health ; and, either mingling with, or over-
coming it, we hear a minute crackling sound, as the air passes in and
out in breathing.
This crackling has been compared to that produced by fine salt
thrown upon red-hot coals ; or by that of rubbing a lock of fine hair
between the thumb and finger near the ear. It is caused by small
bubbles of air being forced along the moist and sticky sides of the
small tubes and air-cells. It is heard only while the breath is being
drawn in.
Second Stage. — If the inflammation advances to the second stage,
the swelling of the diseased lung increases so as to force out the air
entirely, and it becomes solid., and wholly useless for the purpose of
breathing. In solidity and general appearance, it resembles a piece
of liver. Hence it is said to be hepatized, or liverized ; and this is
called the stage of hepatization.
As the lung grows more solid, its vitality and strength diminish;
it is not near as strong as a piece of healthy liver, though it looks
like it; it is soft and easily broken; indeed it seems to be in a state
of commencing decay or rottenness. Hence some writers, in order
to be more precisely correct, cal) this the stage of red softening.
Lungs and Their Diseases.
State of the Lungs in Pleuro-
Pneumonia.
A portion of the tissue of the Lungs
showing Blood Vessels, Capillaries and
Air Tubes — magnified 50 diameters.
Consolidation of Lurtgs in Vesicular
Pneumonia.
For healthy condition of Lungs see Manikin.
DISEASES OF THE CHEST.
297
With increased solidity, there is of course increased dullness on
percussion. When the stethoscope is applied to the chest, we hear
no sound of air passing into and out of the diseased lung ; no natural
rustling, or minute crackling ; but in their stead, we have a kind of
whistling, produced by the air passing back and forth in the wind-
pipe and its branches, but finding no entrance into the solidified air-
cells. The breathing sometimes sounds like a sort of puff, — owing
to the column of air rebounding when refused admission to the
closed-up cells.
The general symptoms now increase in severity. There is greater
difficulty of breathing; the phlegm is more gluey; perhaps some
delirium shows itself ; and the patient grows weaker.
Third Stage. — At this period, the lung changes from red hepa-
tization or red softening to gray hepatization or gray softening, and
matter is now found diffused through its whole substance. The
percussion sounds are much the same as in the second stage. On
listening, we hear more of the rattling sound produced by disturbed
phlegm. The matter raised is thinner, — more like liquid ; and
looks like prune-juice. The symptoms generally indicate that the
patient is sinking. Patients may recover from the first and second
stages, but rarely from the third.
Symptoms — For several days before the disease is pronounced
enough to make the patient appear very sick there is a general discomv
fort of the principal air passages, especially the nose jand throat, in
fact, a great many cases of pneumonia follow a so-called cold, which
has been present for two or three weeks. In others, and in this
disease perhaps the first symptom to be noticed is a chill, mild or
severe, which has no influence upon the severity of the disease that
is to follow. Following this chill comes the fever and usually the
so-called pluritic pain over some portion of either lung, many times
it appears to be over the nipple of the side affected, or it may appear in
the lower chest or even in the back. Shortness of breath caused by the
pain when a deep inhalation is attempted then appears, and though the
pain in the chest may diminish, which is frequently the case, fever and
shortness of breath continues; the appetite leaves, thirst appears to a
greater or less extent, the bowels are usually sluggish, the flush shows
on the cheeks and a distressed, hacking cough, suppressed if causing
too much pain, and the raising of a scanty, dark reddish phlegm,
which, when expectorated into a vessel has a tendency to stick to
the sides, and does not flow freely hke sahva. The disease rapidly
assumes a severe condition, and in favorable cases remains about
the same for five to eight days. During these days mentioned, the
so-called crisis occurs, which is the sudden dropping of the tempera-
ture from 102 to 104 at which height it has been, down to the normal,
which is 98J degrees. The respiration during these times is rapid
and short. The sickness of the patient progressively increases the
298
DISEASES Oi’ THE CHEST.
pulse which is around 100 to 130. The mind is many times clouded,
especially in children or those addicted to liquor.
Treatment. — It is well to understand that in this most serious
disease the best care and maintenance of strength is absolutely
required. There are a certain number of cases that will die m spite
of the best treatment that can be obtained, another number will
get well if not given the wrong treatment or neglected, but a large
middle class between these two extremes will need careful treatment
to carry them through to recovery. There can be no absolute routine
treatment in pneumonia, as the condition of the patient will demand
how much stimulation is needed and what degree of lung tissue is
affected. In the early stages of pneumonia, some depressant to the
increased circulation which will be seen by the rapid beat of the
pulse, is needed, a tincture of aconite or of veratum viride in one
drop doses repeated every half hour until five or eight doses have
been given. Although the temperature will be increased at this
time, a hot mustard foot bath will help the aconite in its action and
relieve temporarily the congestion of the lung. If violent pain in
the chest, due to pleurisy is present, small doses of Dover’s powder
which may be obtained at drug stores and which consists of ipecac
which IS a sweat producer, and morphine which is a pain quieter,
and the combination of these two, act most happily upon the system
in this condition. Thus 5 to 10 grains of Dover’s powders repeated
it the pain continues, every three or four hours will often give great
relief. This remedy must be used only during the first two or three
days, as later on they will only tend to further depress the heart,
which may by this time be showing the effect of the disease. It will
now be necessary to see that the eliminating organs of the body, such
as the bowels, the kidneys and the lungs are kept in a state of active
work, an expectorant such as the prescription recommended under
bronchitis consisting of chloride of ammonia, citrate of potash and
licorice mixture will enable the patient to raise the phlegm and the
citrate of potash will exert a favorable action of the kidneys.
It then remains for us to keep the heart in as good condition as
possible, care being taken not to over-stimulate as the chances are
good for all the stimulants we possess to be needed before the patient
is through the crisis. This is done by the use of strychnia, the
most favorable and digitalis and alcohol in the form of whiskey and
brandy in the order named. Strychnia may be given on the second
and third days, or if not needed then, when the acceleration of the
pulse to above 110 renders it necessary. The dosage may be at first
1 -60 of a gram four times a day : when this dose ceases to hold the
pulse at 110 the dose may be increased to 1-40 of a gram every four
hours, and even later again increased to 1-30 or even 1-20 of a grain,
but of course, these later doses only on the advice of the 'physician 'who has
diseases of the chest.
299
taken charge of the case. Whiskey or brandy in tablespoon doses for
adult every four to six hours will be of temporary service in tiding
the patient over attacks of heart failure. Digitalis in the form of
tincture given in doses of 10 drops three, four or five times during
twenty-four hours may be needed after the third, fourth or fifth days.
The fever will often rise to 103 or 104 degrees and remain at this
point, but as the disease will turn sometime between the fifth and
eighth or ninth days we do not have to use strenuous measures to
reduce the fever unless the patient is very nervous or delirious. In
this latter case tepid or cool water sponging will often relieve the ner-
vous troubles by reducing the fever and enabling the patient to sleep
without artificial aid. A jacket made of sheet-wadding and kept about
the chest is a good precaution if constant care of a nurse is not given.
This will often tend to reduce congestion and surely keeps the chest
from exposure to changes in temperature, should the patient throw
off the clothes. In emergencies which may occur at any time during
the course of the disease and to be watched for especially at the crisis
or turn of the disease, the aromatic spirits of ammonia in half tea-
spoonful^ doses diluted with water may be given every hour for the
stimulating effect. Oxygen is often of value though many times used
without effect. It will quiet labored breathing to some extent and
supply the blood with a necessary article which the consolidation in
the lung IS withholding from it. As soon as possible withdraw what
unnecessary stimulation is being given and through the convalescence
give the expectorant mixture and nourish well with eggs, broth, milk
and hght but concentrated articles of diet. ’
Typhoid Lung Fever. — Typhoid Pneumonia.
This is an inflammation of the lungs, differing from the preceding
only in the character of the fever attending it, which is of a low,
typhoid character. The disease, like typhoid fever, is characterized
by great debility and prostration.
Symptoms. — These are a combination of the symptoms of pneu-
monia and of typhoid fever. The disease begins with great weari-
ness, lassitude, dizziness, pain in the head, back, and limbs. Soon
there is much difficulty of breathing, tightness across the chest, with
a. dry, short, hacking cough.
As the disease advances, the active symptoms pass away ; there is
a dull pain across the chest ; drowsiness is very apt to come on, with
the various symptoms of sinking peculiar to typhoid fever. The
skin is harsh and dry, the temperature uneven, the tip and edge of
the tongue red, and the middle covered with a yellow or brown fur.
The bowels are tender, swollen, and drum-head like ; while there is
often a diarrhoea, — the discharges having a dirty-yellow color.
Treatment. — This should be like the treatment of pneumonia
and typhoid fever united.
300
DISEASES OF THE CHEST.
Great care must be taken not to use reducing remedies. While
active purging must not be used, yet, if there are symptoms of an
inactive state of the bowels, podophyllin and leptandrin (34), (39),
may be employed with advantage.
When there are symptoms of great depression, use tonics (46),
(48), (50), (53), (60), (64), (67), (73), taking care to keep the
cough loose by flaxseed, slippery elm, and marshmallow tea, and by
some external irritant.
Broncho-Pneumonia.
This is an infectious inflammation, characterized by an exudation
from the blood-vessels, the formation of new connective tissue, and
the growth of bacteria. The disease involves the walls of the bronchi
and the air-spaces surrounding the inflamed tubes. It is frequently
called capillary bronchitis and catarrhal pneumonia. It is the ordi-
nary pneumonia of children, and is frequently seen in young people.
It comes on primarily, but is often secondary to measles, whooping-
cough, etc.
Symptoms. — In the very young, the only symptoms are fever,
prostration, and rapid breathing. There is no cough, no physical
signs, but the disease is, almost always, fatal within a few days’ time.
There is a great difference in the invasion of the disease in dif-
ferent cases, the severer cases being ushered in by one or more con-
vulsions, by rapid rise of temperature, vomiting, difficulty in breathing,
and delirium; the milder cases beginning with lower temperature,
moderate prostration and shortness of breath.
The height of the temperature is, as a rule, in proportion to the
severity of the disease. Temperatures of 105° and over are usually
fatal. The pulse reaches 150 to 170 in adults, and even higher in
clhldren, — so high, in fact, that it cannot be taken. The respiration
varies from 40 to 80. Sleeplessness, restlessness, and even delirium
are frequently present. The face is flushed, the tongue coated, and
oftentimes diarrhcea and vomiting occur. Cough is usually present,
and in the young the sputum is swallowed. The urine is frequently
albuminous and contains casts.
Between the second and fifth days the signs of consoHdation and
pleurisy appear, i. e., dullness on percussion, bronchial breathing and
bronchophony with crepitant rattles.
The duration of the disease in children varies : of the fatal cases
the majority die within the first fortnight. The cases which recover
vary from one to three weeks, though many persist for six and eight
weeks. The softening and absorption which occurs in all pneumo-
nias that recover occupy a much longer jreriod in broncho-pneumo-
nia than in lobar pneumonia.
Many cases of broncho-pneumonia are complicated by cerebral
symptoms of convulsions, delirium, stupor, vomiting, etc., even before
4
DISEASES OF THE CHEST.
301
any marked lesions in the lungs appear; as these subside the lung
symptoms appear. Many cases are protracted for a long time, and
though they may terminate favorably at last, yet they are apt to run
into a chronic hardening of the lung which lasts for years ; or they
recover with a permanent consolidation of the lung. Some die of
exhaustion.
Treatment. The use of hot fomentations and poultices over the
chest and the administration of small doses of ipecac and aconite at
short intervals soothe the bronchitis and pain.
For the cerebral symptoms, phenacetin and the bromides are very
useful. Aconite and digitalis are usually employed when the pneu-
monia stage comes on. As a rule stimulants are not required in
children, in whcfm the disease most frequently occurs.
In convalesence, iron, quinine, cod-liver oil, oxygen and a change
of air are to be recommended. °
Other Forms of Lung Inflammation.
Of the various other forms of lung inflammation which occur
mention may be made of pneumonia dependent on Heart Disease i
Interstitial Pneumonia, or the formation of new connective tissue
and obliteration of the air-spaces ; Tubercular Pneumonia, which is
caused by the presence of tubercle bacilli; Acute and Chronic Mi-
lia^ Tuberculosis, characterized by the presence of numerous minute
nodules called miliary tubercles; Acute and Chronic Tubercular
Consumption ; Gangrene of the Lung, where a portion of the lung
has lost its vitality and the germs of putrefaction have entered.
Asthma.
Asthma may be defined to be great difficulty of drawing in the
breath, — coming on suddenly, sometimes gradually, — accompanied
with a sense of extreme suffocation, and a desire for fresh air ; con-
tinuing for a longer or shorter period, and then passing away, and
leaving the patient a period of comparatively easy respiration.
Symptoms. — There are sometimes no premonitory symptoms
■he attack coming on suddenly, and without warning 5 but more fre^
quently there are, for some days before the onset, loss of appetite,
tiatulence, belching of wind, irritability, languor, chilliness, oppres-
sion, and drowsiness. The hard breathing generally makes its
appearance in the night, — quite often at three or four o’clock in
the morning, when the nervous system is at its lowest ebb. There
IS first a sense of tightness, or stricture, across the chest, which
seems to expand with difficulty. The patient can no longer remain
lying down; he rises up, draws up his knees, and, leaning forward,
puts his elbows upon them, and his head upon his hands, and then
s ruggles hard to draw in his breath ; which, passing in slowly and
302
DISEASES OF THE CHEST.
laboriously, produces a loud wheezing sound. Sometimes he feels
that he must have fresh air, and, rushing to a window, puts his head
far out, to catch a stirring breeze. The hands and feet are cold, the
face haggard and distressed, — sometimes a little red and swollen,
but more generally pale and shrunk, — the body wet with perspira-
tion, the pulse irregular, feeble, and small, though sometimes not
disturbed. These symptoms continue for some hours, more or less,
when the breathing becomes more easy, and there is a little phlegm
raised, sometimes considerable. This cessation of difficult breathing
may be complete, or only partial ; and lasts for a longer or shorter
period, when the attack again recurs.
Causes. — It is well known that Asthma has its cause mainly in
the nervous system. The air-tubes are encircled with a series of
little bundles of fibres, which are, in fact, muscles, and like all other
muscles have the power of contracting or shortening themselves.
These muscles, too, like all others, have nerves distributed to
them ; and when these nerves become diseased or irritable, they will
become disturbed on certain occasions, and cause these small, circu-
lar puckering strings to contract and close up the air-tubes near
their terminations, very much as the puckering-string closes the
mouth of the work-bag, so that very little air can pass into the air-
cells, and that little with great difficulty and slowness. When these
contractions take place, and the air is thus shut off, the result is a fit of
asthma. This disease may be brought on by any of those states of
the atmosphere which disturb or irritate the bronchial surfaces, or by
any of the numerous causes which mysteriously unbalance the
nervous system. A fit may be brought on by whatever disturbs the
mind.
In addition to this cause which is known as the bronchial type of
asthma there are the cardiac and iieiihritic types. The so-called
cardiac asthma, in the early stages is perhaps more amenable to treat-
ment than the bronchial type but its course would not be effected
by the drugs given for the latter type and appropriate remedies for
the heart must be given. In the nephritic type the asthma is due
to the retention in the system of the poison which is prevented
from passing out of the body in the urine because of disease of the
kidneys.
Treatment. — The disease has been regarded as extremely diffi-
cult of cure. There are certain remedies, however, which have a
remarkable control over it, and, if skilfully used, will frequently
bring it to a complete termination, and, even in the worst cases, to a
state of very great mitigation and improvement.
Inhalation. — The most important and certain remedy is the use
of the Alterative Inhalant, described on page 273. I have with this
article alone effected some surprising cures ; yet it is well to combine
DISEASES OF THE CHEST. 303
other treatment with it. I have had several cases of a most distress-
ing character, — the attacks continuing night and day, — in which
the inhalation, judiciously administered, has caused the disappearance
of the complaint within twenty-four hours, and in which no return of
suffering has occurred for several weeks, and then only in a modified
form. This remedy should be used four or five times a day.
Iodide of potassium is a most valuable internal remedy in this
complaint; indeed, in a certain sense, it is almost a specific. It
should be used (prescriptions 101, 138, 140, 151) at the same time
with the inhalation. The following preparation is a very good
remedy for this disease : Ethereal tincture of lobelia, two ounces ;
tincture of asafoetida, one ounce ; grindelia, one ounce ; iodide of
potassiurh, two ounces ; simple syrup, four ounces. Mix. Dose,
from a teaspoonful to a tablespoonful, every hour or two.
Several other remedies are used for asthma, with more or less
success, such as electro-magnetism, smoking stramonium leaves,
burning paper dipped in a strong solution of nitrate of potash, and
inhaling the smoke, etc., ■ — but none of these have as much value as
the two remedies first named.
For the cardiac type strychnia, digitalis, spartine, strophanthus and
cocaine in appropriate dosage must be given to effect an improve-
ment. For the kidney type relief of the system by other channels
than the kidneys, until they are in better working order will be
necessary. This can be accomplished by the use of saline cathartics
such as one or two teaspoonfuls of epsom salts diluted with water,
given often enough to cause two or three watery discharges during
twenty-four hours. In addition to this sweating of the skin by
means of hot lemonade or small doses of Dover’s powders in hot
drinks may be given.
In as grave a complaint as a severe case of asthma, it is always
well to seek the aid of a physician.
Hay= Asthma. — Hay=Fever.
This is a very troublesome complaint, which seems to combine
the peculiarities both of asthma and of influenza. Fortunately, it
attacks but few persons, and those only at particular seasons of the
year, — namely, while hay is in blossom, and during hay-making.
Symptoms. — These are a combination of the symptoms of the
two diseases above named. There is great irritation of the eyes,
with sneezing, and a free discharge from the nose. There is
tightness across the chest, difficulty of breathing, and a pricking
sensation in the throat. These symptoms often appear in great
severity, making the complaint a really distressing one.
Cause. — This disorder appears to have but one cause, — namely,
some sort of emanations from the grasses, flowers, etc., while in
blossom ; which emanations come in contact with the mucous lining
of the eyes, nose, and throat, producing very great and teasing irri-
tation.
304
DISEASES OF THE CHEST.
Treatment. — One of the best remedies for this troublesome com-
plaint is to avoid the cause, by removing, during the flowering and
haying season, to some large city, or, still better, close down to the
seashore, where flowers and hay do not grow.
Of medicines, the tincture of lobelia, taken in moderate doses, is
a very good remedy. Quinine and iron, given in combination (75),
are valuable preparations. Strychnine and nux vomica, in connec-
tion with iron or otherwise (316), (83), (84), (85), (86), (95), are
very useful. Iodide of potassium (101), (138), (140), is also worth
a trial. Another very good remedy is the chloride of lime, or the
chloride of soda, placed in saucers about the sleeping-room. Pieces
of cotton cloth may also be dipped in one of these solutions, and
hung about the apartments of the house. The hands and face may
likewise be washed, once or twice a day, in a weak solution.
The oxide of zinc and the extract of nux vomica, made into pills,
two grains of the zinc to half a grain of the extract to each pill, and
one pill taken morning and evening, should not be forgotten.
Of late cocaine, painted by means of a camel’s hair brush on the
mucous membrane of the nose, has been used to check a paroxyism
and mitigate the disease.
The following formula is the most efficacious of this class of
remedies and should be painted onto the nasal mucous membrane as
high up as possible ; its use may be repeated several times till the
membrane becomes numb.
Cocaine 12 gr.
Antifebrin 25 gr.
Alcohol 1 dr.
Simple Elixir ........... 3 dr.
Mix and shake before using.
DISEASES of the HEART
HEART DISEASES.
(Also see Anatomy of Organs of Circulation.)
Life rests upon a tripod, — the brain, the lungs, and the heart.
These are equally important to its well-being and continuance.
In substance, the human heart is a bundle of muscles, so put to-
gether as to bear the greatest possible amount of work. In size,
shape, and look, it is much like the heart of the hog. I wish it
never had a likeness to it in its moral nature.
The heart is enclosed in a case or sac, called the pericardium. It
lies between the two lungs, a little to the left side of the chest. Its
point is under the sixth rib on the left side, and its lower surface
rests on the diaphragm, — a horizontal partition between the chest
and belly.
The heart is double. It has four cavities, — two for receiving the
blood, which are called auricles^ and two for driving it out, called
veyitricles.
The venous, or dark blood, is brought from all parts below, and
emptied into the right auricle through the ascending vena cava, and
from all parts from above, and pour into the same cavity through
the descending vena cava. From this it passes into the right ventri-
cle, which contracts, and forces it through the pulmonary artery into
the lungs, where it becomes red, and passes into the left auricle
through the jjulmonary vein, thence into the left ventricle, which
contracts, and throws it out through the great aorta to all parts of
the body. Fig. 95 gives a good idea of the circulation through the
heart and lungs.
The heart is divided into two sides, which are separated from each
other by a muscular partition, — each side having an auricle and a
ventricle.
The auricles have comparatively thin walls, as they are only used
for reservoirs. The walls of the ventricles are much thicker, being
used, — particularly that of the left side, • — for forcing the blood
over a large surface.
Between the auricle and ventricle on the right side, are three folds
of triangular membrane, called the tricuspid valves. Between the
auricle and ventricle on the left side, are three valves, called mitral.
At the beginning of the pidmonary artery, and the aorta, are three
half-moon shaped folds of membrane, called semilunar valves.
306 •
HEART DISEASES.
307
The office of all these valves is, to close after the blood has gone
through, and prevent its flowing back while the cavity is being again
filled. They do the same duty, in fact, as the valves of a pump.
Through this heart, thus constructed, all the blood in the body, —
about twenty-eight pounds, — passes once in about one minute and a
half. This is rapid work; and when we consider that the heart
works in this way through the whole life, resting not, day or night,
we cannot wonder that it gets out of order.
Fig. 95.
The whole heart is seldom affected. The left side is more liable
to disease than the right.
Impulse of the Heart.
The ear, when placed over the heart, feels, at each beat, a slight
shock. This is felt at the same time the first sound is heard. This
impulse is caused by the apex or point of the heart being thrown up
against the ribs by the contraction of the ventricles. It is felt best
between the cartilages *of the fifth and sixth ribs on the left side.
The Sounds of the Heart.
On applying the ear to the chest just over the heart, two sounds
are heard. The first one is dull and slightly prolonged ; the second
is a shorter and smarter sound, having a sort of clack. These occur
in pretty rapid succession, and then comes a brief interval. And this
round of action, first a long and dull sound, then a short and smart
one, and then an interval, — called the heart’s rhythm, — is repeated
continually. If the space of time occupied by the rhythm be divided
308
HEART DISEASES.
into five parts, the first sound will take about two parts, the second
one, and the interval of repose, the remaining two. The first sound
is heard about the time of the contraction of the ventricles, and is
therefore called the systolic sound ; the second is synchronous with
the opening of the ventricles, and is called the diastolic sound. The
syllables too-to — too-to, very fairly represent the two sounds of the
heart. These sounds are heard over the largest space in lean
persons.
Percussion Sounds.
If the ends of the fingers be struck upon the chest over the heart,
a dull sound will be heard over a space from one and a half to two
inches square, — beginning at the fourth rib on the left side, and ex-
tending down nearly to the sixth. The dullness is diminished by
lying upon the back, and increased by leaning forward, and by taking
a full breath. The deadness of sound is caused by the heart being
a partially solid body. The lungs which surround it yield a clear
sound.
If a solid substance, as large as the heart, were placed on the in-
side of a drum, against the head, only a dead sound would be ob-
tained by striking on that spot ; everywhere else, the sound would
be louder.
Altered Sounds of the Heart. *
These sounds are changed by disease in a variety of ways, both as
to their character and duration. One or both sounds may be turned
into a noise like the blowing of a pair of bellows. This is called the
bellows sound. When this sound is very harsh, it may become like
the noise of a rasp, or file, or saw. These altered sounds are all pro-
duced by an altered condition of the valvular passages through
which the blood passes. If you build an aqueduct of equal dimen-
sions throughout, and smooth on the inside, you may send a certain
volume of water through, at a given speed, without noise. But if
you make sudden contractions in the aqueduct, or allow large stones
to project into it, and then attempt to send 
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